The concern, imo, is less the choice of sedation as the degree of medical management of conscious or unconscious sedation.
There is a medical article in the "Files" section of Very Young Kids Teeth about in sedation risks called "CONSCIOUS SEDATION.doc ". The degree of responsiveness of the patient is the defining variable. In hospital/out-patient, it is required that (1-2) licensed anesthesiologist along with multiple personnel certified in ACLS (Advanced Cardiac Life Support) are present and available during general anesthesia.
I was a critical care nurse, so understood the measures required for conscious sedation in hospital. Oxygen saturation, oxygen supplementation, IV access, emergency drugs for respiratory compromised incidents are available in an outpatient setting.
The dangers of Chloral Hydrate are covered in that article. Chloral Hydrate is highly associated with children's deaths. Plain and simple, no way would I give this to my child when he is not under constant medical observation with oxygen saturation measurement. But, the respiratory depression effects can be lethal. This drug is even contra-indicated for sedation dentistry for children due to its risks.
I investigated the clinical research related to sedation dentistry for our son. Here are some of the studies. The studies evaluate the risks of chloral hydrate for children, in a controlled and monitored setting.
Adverse Sedation Events in Pediatrics: Analysis of Medications Used for
Sedation of anxious children undergoing dental treatment.pdf:http://f1.grp.yahoofs.com/v1/8DxqSsSGkiJHFLqW_4jjQePzUfaRXo5Ym1OMRKXexD_ea3QA9E 0\
Sedation disasters in pediatrics and concerns for office based practice:http://f1.grp.yahoofs.com/v1/8DxqSpeMZhxHFLqWBJjPSFpZ7PyEBuEN4bQkfNgDXv1oQlbi-iu\
The ability to proscribe and measure the dose accurately is critical due to the different liver metabolism of children by age. The half-life and peak effects are different than in adults. Multiple children have died after taking chloral hydrate before dental treatments due to the respiratory depression effect.
Additionally, it has a risk of carcinogenicity:http://aappolicy.aappublications.org...trics;92/3/471http://www.drugs.com/cons/chloral-hydrate.htmlhttp://www.rxmed.com/b.main/b2.pharmaceutical/b2.1.monographs/CPS-%20Monographs/\
This link does not even provide for dosing administration of syrup for children, by non-professionals. The risk of mis-measuring is too great! The syrup is only to be administered by a professional in an observed environment.http://drugspedia.net/prep/41291.html
All in all, the post-procedure respiratory risks of Chloral Hydrate are unnecessary and unpredictable, in an outpatient setting, when you are going home afterward, imo. Versed has a short half-life and is much easier to manage. It comes po or nasally. We avoid artificial colors and flavors, so chose the nasal dosage route. It worked great!
ETA: is the surgery essential 'now'. I would wait until optimal timing (no illness for four weeks, no recent vaccinations or out of town respiratory exposures, limited allergen exposures, etc.). Generally, summer, rather than winter is optimal, with less 'flu/cold season' concerns, however.