sleep inducing for eeg recording in children: a comparison between oral midazolam and chloral hydrate

how to cite this article: ashrafimr, azizi malamiri r, zamani gr, mohammadi m, hosseini f. sleep inducing for eeg recording in children: a comparison between oral midazolam and chloral hydrate. iran j child neurol. 2013 winter;7(1):15-19. objective electroencephalography (eeg) recording is a long duration procedure that needs patient’s cooperation for device setup and performing the procedure. many children lose their cooperation during this procedure. therefore, sedation and sleep are frequently induced using a few agents as pre procedure medication in children before eeg recording. we aimed to compare the sedative effects of oral midazolam versus chloral hydrate before the procedure along with their impacts on eeg recording in children. material s & methods a randomized trial was carried out to compare the sedative effects of oral midazolam versus chloral hydrate and their impacts on eeg recording in children. a total of 198 children (100 in the midazolam group and 98 in the chloral hydrate group) were enrolled in the study and randomly allocated to receive either oral moidazolam or chloral hydrate. results oral midazolam had superiority neither in sleep onset latency nor in sleep duration when compared to chloral hydrate. moreover, the yield of epileptiform discharges in the chloral hydrate group was more than the midazolam group. conclusion the results of this study showed that both chloral hydrate 5% (one ml/kg) and oral midazolam (0.5 mg/kg) could be administered as a pre medication agent for eeg recording in children. however, oral midazolam at this dose had no advantage compared with chloral hydrate. references ashrafi mr, mohammadi m, tafarroji j, shabanian r, salamati p, zamani gr. melatonin versus chloral hydrate for recording sleep eeg. eur j paediatr neurol 2010;14(3):235-8. slifer kj, avis kt, frutchey ra. behavioral intervention to increase compliance with electroencephalographic procedures in children with developmental disabilities. epilepsy behav 2008;13 (1):189-95. gauillard j, cheref s, vacherontrystram mn, martin jc. [chloral hydrate: a hypnotic best forgotten?]. encephale 2002;28(3 pt 1):200-4. cote cj, karl hw, notterman da, weinberg ja, mccloskey c. adverse sedation events in pediatrics: analysis of medications used for sedation. pediatrics 2000;106(4):633-44. greenblatt dj, ehrenberg bl, culm ke, scavone jm, corbett ke, friedman hl, et al. kinetics and eeg effects of midazolam during and after 1-minute, 1-hour, and 3-hour intravenous infusions. j clin pharmacol 2004;44(6):605-11. gurakan f, yuce a, ozen h, saltic in. midazolam and pethidine for the sedation of children undergoing gastrointestinal endoscopy. crit care med 2000;28(6):2176-7. karl hw, cote cj, mccubbin mm, kelley m, liebelt e, kaufman s, et al. intravenous midazolam for sedation of children undergoing procedures: an analysis of age- and procedure-related factors. pediatr emerg care 1999;15(3):167-72. lightdale jr, mitchell pd, fredette me, mahoney lb, zgleszewski se, scharff l, et al. a pilot study of ketamine versus midazolam/fentanyl sedation in children undergoing gi endoscopy. int j pediatr 2011; 2011:623710. massanari m, novitsky j, reinstein lj. paradoxical reactions in children associated with midazolam use during endoscopy. 1997;36(12):681-4. scott rc, besag fm, boyd sg, berry d, neville bg. buccal absorption of midazolam: pharmacokinetics and eeg pharmacodynamics. epilepsia 1998;39(3):290-4. loewy j, hallan c, friedman e, martinez c. sleep/sedation in children undergoing eeg testing: a comparison of chloral hydrate and music therapy. am j electroneurodiagnostic technol 2006;46(4):343-55. rodriguez e, jordan r. contemporary trends in pediatric sedation and analgesia. emerg med clin north am 2002;20(1):199-222. sisson df, siegel j. chloral hydrate anesthesia: eeg power spectrum analysis and effects on veps in the rat. neurotoxicol teratol 1989;11(1):51-6. thoresen m, henriksen o, wannag e, laegreid l. does a sedative dose of chloral hydrate modify the eeg of children with epilepsy? electroencephalogr clin neurophysiol 1997;102(2):152-7.