Comment on “Systematic Review and Meta-analysis of Efficacy and Safety of Melatonin and Triclofos for Inducing Adequate Sedation for sleep EEG in Children”
Abstract
Sleep state is vital for recording electroencephalogram (EEG), as it decreases the artifacts and can unwind certain epileptiform discharges (EDs). However, attaining the sleep state in children, especially in children with developmental challenges, is often tricky. To achieve this sleep state in uncooperative patients, both children and adults, oral sedatives are used for prompting sleep, in order to assist in performing EEG. Sedation can be defined as a state of drowsiness or sleep from which a patient can be roused.1 In a sedated state, patients’ vital respiratory reflexes remain intact, and they can respond to verbal commands. Scottish Intercollegiate Guidelines Network guideline is a national clinical guideline developed to highlight the special considerations for sedation in children.2 Various medications such as benzodiazepines, barbiturates, etc., have been tried in the past to achieve sedation. However, these drugs were noted to affect EEG recordings by either warping the background readings or stifling the EDs. Therefore, natural sleep was preferred for performing EEGs. To achieve this natural sleep state in uncooperative children, drugs such as chloral hydrate, chlorpromazine, and promethazine were previously favored. However, these drugs also lost their popularity over time due to their unacceptable adverse drug effects (ADE) profiles like prolonged sedation, respiratory depression, hypotension, and desaturation in certain cases. This lead to the advent of drugs…
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