Chloral hydrate for sedation of children with asthma during dental treatment

Authors:

ABSTRACT

Aim

We hypothesised that chloral hydrate is safe and effective for sedation during dental treatments for children with mild
asthma. We evaluated the safety and efficacy of chloral hydrate by measuring changes in heart rate (HR), transcutaneous oxygen
saturation, (SpO2), asthma score, behaviour, types and frequency of adverse reactions associated with chloral hydrate were assessed
throughout treatment.

Methods

Children (<10 years old) with mild asthma undergoing dental treatments received a single 65 mg/kg oral dose of chloral hydrate liquid 1 hour prior to treatment in an open label trial. Heart rate (HR), SpO2, asthma score, behaviour, types and frequency of adverse reactions associated with chloral hydrate were assessed throughout treatment. Asthma score was obtained before and after treatment. Thirty minutes after treatment, SpO2, HR, and level of consciousness was assessed.

Results

Twenty four children were enrolled and 92 (22/24) recovered from sedation without respiratory
depression. Two experienced mild respiratory depression related to chloral hydrate. Asthma was not a contributing factor as they did not
experience wheezing, cough, tachypnoea, or retractions. Inhaled nitrous oxide supplemented chloral hydrate sedation in 63
(15/24) children to achieve effective cooperation. Three children had a SpO2 <95 (2 during treatment, 1 during recovery).

Conclusion

Chloral hydrate 65 mg/kg administered a as single oral dose appears to be safe with respect to disease exacerbation
for children with mild asthma undergoing dental treatment. Due to ineffective sedation and mild respiratory depression associated with
chloral hydrate, newer, easily titrated medications, such as midazolam, may offer advantages.

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