The use of oral pentobarbital sodium (Nembutal) versus oral chloral hydrate in infants undergoing CT and MR imaging - a pilot study

Background. Chloral hydrate, a commonly used oral sedative for infants undergoing imaging examinations. has a bitter taste and requires relatively large volume, provoking unpleasant reactions from the infants. Experience with an alternative sedative, oral pentobarbital (Nembutal), has not been reported for infants. Objective. To compare patient acceptance of oral Nembutal and oral chloral hydrate for sedation of infants up to 12 months of age. Methods and materials. Fifty-four infants (mean age: 7 months) were prospectively enrolled. Parents chose Nembutal, chloral hydrate, or no preference. Thirty-eight infants received Nembutal (4-6 mg/kg) mixed with cherry syrup and 16 received chloral hydrate (50-100 mg/ kg). We recorded infant's acceptance of sedative, parental impression of infant's acceptance, time to sedation, time to discharge, adverse effects, parental preference of future sedative. Results. Infant acceptance and parental impression were better for Nembutal (P < 0.0001). Fewer parents in the Nembutal group preferred another sedative (P = 0.05). There was a trend toward shorter time to discharge with Nembutal (P = 0.03), There were no adverse effects in either group. One infant failed to sedate with Nembutal. Conclusions. Compared with chloral hydrate, oral Nembutal has significantly better acceptance by infants and parents, equal effectiveness, and may result in a shorter time to discharge.