Table 5. Summary of postoperative adverse events including death case.
| First author/publication year | Age (month) | Sample size | Sedative drugs (mg/kg, %) | Monitoring period | Results |
|---|---|---|---|---|---|
| Huang A 2015 [10] | 84 | 7 | CH, Mep, Hy | 24 hours after discharge | Excessive somnolence |
| Nordt SP 2014 [11] | 48 | 1 (1F) | CH (70) | Discharge after 1 hour, remained somnolent but arousable | |
| Ongoing somnolence for 6 hours | |||||
| Post-discharge death by respiratory arrest | |||||
| McCormack L 2014 [12] | 55 | 40 (21M, 19F) | CH (30), Mep (2), Hy (2), N2O-O2 (30-50) | Post-operation before discharge, 8, 24 hours after discharge | CH combination regimen exhibited significantly more sleeping after arriving home, less talking, and greater need for postoperative pain medications up to 8 hour after discharge |
| Mdz (1), Mep (2), Hy (2), N2O-O2 (30-50) | |||||
| Costa LR 2012 [15] | 43.2 | 42 (22M, 20F) | CH (70) | 24 hours after discharge | Minor post-discharge adverse events(falling asleep, difficult to awake) were common, significantly more associated with CH than Mdz |
| CH (100) | |||||
| Mdz (1.0) | |||||
| Mdz (1.5) | |||||
| Kupiec TC 2011 [16] | 72 | 1 (1M) | Meth (2), Hy (1.64), CH (15), N2O-O2 | Medical history of asthma | |
| Patient appeared responsive but groggy after procedure, | |||||
| taken home and fell asleep | |||||
| Dead after few hours of procedure | |||||
| Post-discharge death by drug cocktail | |||||
| Martinez D 2006 [18] | 24-60 | 30 (14M, 16F) | CH (20-30), Mep (1-2), Hy (1-2), N2O-O2 (50) | Post-operation before discharge, 24 hours after discharge | Children having combination regimen containing CH were more likely to sleep on the way home and at home than those received Mdz alone |
| Mdz (0.5-0.75), those received Mdz alone N2O-O2 (50) | |||||
| Dallman JA 2001 [23] | 41.8 | 31 (23M, 8F) | Mdz (0.2), N2O-O2 (25-50) | 20 minutes after operation | Mdz group met discharge criteria more quickly than CH group |
| CH (62.5), PZ (12.5 mg), N2O-O2 (25-50) | 1 vomiting case | ||||
| Engelhart DA 1998 [28] | 24 | 1 (1M) | CH (95), N2O-O2 | Following surgical procedure, patient transported to emergency room after 2 h of administration, dead after 2.3 h of administration | |
| Post-discharge death by overdose of CH, combined effect of CH, lidocaine, N2O | |||||
| Sams DR 1990 [29] | 31 | 24 | CH (50), PZ (1), N2O-O2 (< 50) | 30 minutes, 24 hours after discharge | 2 postoperative pain |
| 6 increased anxiety/irritability | |||||
| 2 fever | |||||
| 35.8 | Mep (1), N2O-O2 (< 50) | 2 postoperative pain | |||
| 1 increased anxiety/irritability |
CH, chloral hydrate; Mep, meperidine; Hy, hydroxyzine; Mdz, midazolam; Meth, methadone; PZ, promethazine