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.