Efficacy and safety of chloral hydrate combined with dexmedetomidine for sedation during echocardiography in pediatric patients with Williams-Beuren syndrome

Abstract

Objective To evaluate the efficacy and safety of chloral hydrate combined with dexmedetomidine for sedation during echocardiography in pediatric patients with Williams-Beuren syndrome. Methods Eighteen pediatric patients diagnosed with Williams-Beuren syndrome by genetic testing, aged 5-58 months, scheduled for elective echocardiography under sedation, received oral chloral hydrate 50 mg/kg.Vital signs were measured every 5 min, and sedation was assessed using Ramsay sedation score.When Ramsay sedation score<4 points 20 min later, intranasal dexmedetomidine 1 μg/kg was given as rescue sedative.Medicine used, vital signs, onset time, moderate and deep sedation duration and emergence time were recorded. Results The success rate of sedation with chloral hydrate alone was 38.9% and with chloral hydrate and dexmedetomidine 61.1%.The onset time, sedation duration and emergence time were(15.7±1.9) min, (75±26) min and(52±25) min, respectively, in pediatric patients received chloral hydrate alone.The onset time, sedation duration and emergence time were(33.2±3.4) min, (83±49) min and(61±46) min, respectively, in pediatric patients received chloral hydrate and dexmedetomidine.The onset time was significantly prolonged in pediatric patients received chloral hydrate and dexmedetomidine than in pediatric patients received chloral hydrate alone(P<0.05). Heart rate, respiratory rate and SpO2 were stable during sedation in all pediatric patients, and nausea and mild vomiting were found in 3 pediatric patients received chloral hydrate and in 6 pediatric patients received chloral hydrate and dexmedetomidine, and no other adverse reactions were observed. Conclusion Oral chloral hydrate 50 mg/kg combined with intranasal dexmedetomidine 1 μg/kg provides reliable sedative efficacy and exerts less influence on respiratory and circulatory function with higher safety when used for echocardiography in pediatric patients with Williams-Beuren syndrome. Key words: Dexmedetomidine; Chloral hydrate; Heart diseases; Echocardiography, doppler, color; Conscious sedation