The Efficacy and Safety of Oral Pentobarbital Sedation in Pediatric Echocardiography

Background: Because patient movement during echocardiography interferes with diagnostic quality, many institutions sedate children who are unable to cooperate. The purpose of this review was to determine the efficacy and safety of oral pentobarbital for sedation during pediatric transthoracic echocardiography. Methods: Echocardiography laboratory quality assurance data were recorded for 12 years. Sedation data included adverse events, dosing, and failed sedation. The study population was grouped by age: neonates (<1 month), infants (1-12 months), and young children (1-4 years). Results: A total of 9796 patients underwent sedation by oral pentobarbital. The overall sedation success rate was 98.7%, and 99% of these patients remained sedated long enough for study. The overall adverse event rate was 0.5%. Second doses, failed sedation, and adverse events were more common in the young children. Conclusion: Oral pentobarbital is an effective and safe sedative for pediatric transthoracic echocardiography. Because of decreased efficacy and an increased incidence of adverse events, alternative sedation strategies may be beneficial in children aged 1 to 4 years. (J Am Soc Echocardiogr 2010;23:33-7.)