How to calculate the pedicloryl dosage for infant under going bera test
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Pedicloryl chloral hydrate dosage infants BERA test sedation
Here is a complete guide to calculating Pedicloryl (Chloral Hydrate) dosage for infants undergoing a BERA (Brainstem Evoked Response Audiometry / ABR) test:
What is Pedicloryl?
Pedicloryl is the brand name for chloral hydrate oral solution (commonly available as 200 mg/5 mL or 500 mg/5 mL). It is a sedative-hypnotic used to keep infants and young children asleep during painless diagnostic procedures like BERA/ABR tests, MRI, and CT scans.
Dosage Calculation for BERA/ABR Test
Standard Dose
| Parameter | Value |
|---|---|
| Dose | 50 mg/kg (range: 30-75 mg/kg) |
| Maximum single dose | 1000 mg (1 g) |
| Route | Oral |
| Timing | 30-60 minutes before the procedure |
| Age restriction | Infants > 1 month old; weight < 20 kg |
A PubMed study on chloral hydrate for ABR testing in 635 children found the average effective dose was 52 mg/kg, with a 95.9% sedation success rate.
Step-by-Step Calculation
Formula:
Dose (mL) = [Weight (kg) × 50 mg/kg] ÷ Concentration of Pedicloryl (mg/mL)
Pedicloryl Oral Solution concentration: typically 200 mg/5 mL = 40 mg/mL
Example: 6 kg infant
- Dose required = 6 kg × 50 mg/kg = 300 mg
- Volume = 300 mg ÷ 40 mg/mL = 7.5 mL
Quick Reference Table
| Weight (kg) | Dose at 50 mg/kg | Volume (200 mg/5 mL) |
|---|---|---|
| 3 kg | 150 mg | 3.75 mL |
| 4 kg | 200 mg | 5.0 mL |
| 5 kg | 250 mg | 6.25 mL |
| 6 kg | 300 mg | 7.5 mL |
| 8 kg | 400 mg | 10.0 mL |
| 10 kg | 500 mg | 12.5 mL |
Important Clinical Notes
- Neonates (< 1 month): Avoid chloral hydrate in general ward/audiology settings. Natural sleep (feed and wrap technique) is preferred.
- Onset: 30-60 minutes; duration 1-2 hours (can last up to 8 hours in neonates due to a longer half-life).
- Repeat dose: If the child is not sedated after 30-45 minutes, a half dose (25 mg/kg) may be given once. Total dose must not exceed 80 mg/kg or 2 g.
- Monitoring: Keep the child under observation with pulse oximetry. A trained nurse or physician should be present.
Contraindications / Cautions
- Severe liver or kidney disease
- History of cardiac arrhythmia
- Respiratory compromise or sleep apnea
- Do NOT combine with other CNS depressants unless prescribed
Common Side Effects
- Vomiting/nausea (give on empty stomach or light feed)
- Paradoxical agitation (1-2% of cases)
- Prolonged sedation
- Respiratory depression (rare, more risk in premature infants)
Always confirm the exact dose with the prescribing physician, as dosing may be adjusted based on the infant's gestational age, weight, and clinical status. The Children's Health Ireland oral sedation guidelines and Drugs.com chloral hydrate dosing are useful clinical references.
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