Is administration of enteric contrast material safe before abdominal CT in children who require sedation? Experience with chloral hydrate and pentobarbital.

OBJECTIVE: It has been common practice to administer enteric contrast material in preparation for abdominal CT in children who require sedation to be examined. At some institutions, the practice of administering an anesthetic or enteric contrast material before sedation is being challenged because it violates the "nothing by mouth" status that is otherwise strictly enforced before sedation. Our purpose was to review our safety record in administering enteric contrast material for CT before sedation.

MATERIALS AND METHODS: Radiology reports, medical records, and department incident reports were reviewed for the past 5 years from all patients who required sedation for abdominal CT. Patient age and sex, type of sedation, and complications (defined as vomiting with aspiration) related to enteric contrast material before the sedation were recorded. For routine oral contrast material, diluted Hypaque (meglumine diatrizoate) was administered in an age-based amount 1-2 hr before scanning. For sedation, depending on the patient's age, either oral chloral hydrate (70-100 mg/kg) or IV pentobarbital (3 mg/kg with repeated doses of up to 7 mg/kg) was used.

RESULTS: Three hundred sixty-seven patients who received oral contrast material before sedation for abdominal CT were identified (200 boys, 167 girls; age range, 1 month-19 years; mean age, 2.9 years). Chloral hydrate was used in 30 patients and IV pentobarbital in 337 patients. No complications related to the administration of oral contrast material before sedation were identified.

CONCLUSION: The practice of administering oral contrast material in children before sedation for abdominal CT appears to be safe when using the sedation drugs and protocols in place at our institution. Further study of the safety of this practice should be undertaken.