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Gamma hydroxybutyrate (GHB) is a simple four carbon molecule which is a natural constituent of many mammalian tissues in the central nervous system (CNS) and in several tissues of the body. The synthesis of GHB is not the same in the central nervous system and in peripheral tissues. GHB modifies the rates and/or the levels of the synthesis of several neurotransmitters. Its natural presence in the CNS, its pharmacological effects and its action on various behaviours have raised the problem of GHB as a neurotransmitter. GHB can reduce energy substrate consumption in both brain and peripheral tissues and it can protect these tissues from the damaging effects of anoxia. In conditions of anoxia or excessive metabolic demand endogenous GHB levels rise. GHB seems to act through the endogenous opioid system. GHB natural function would be to induce the state of hibernation in which one can evidence a trance-like state and hypothermia with high rates of GHB. The synthesis of GHB through a reductive process and breakdown through oxidation suggest that it accumulates under hypoxic conditions. On top of its present clinical use as hypnotic, general anesthetic and in neurotraumatology, GHB would have therapeutic applications in states of anoxia that generates amino-acid excitators and free radicals.

Sixty-four infants and children under 14 years of age had a neuro-sedation, for a cranial C.-T. Scan. This entirely painless procedure requires complete immobility of the patient. We used two sorts of methods: for infants under eight months of age, a premedication followed by a feeding-bottle is sufficient. For children over eight months of age, intravenous administration of gamma-hydroxy-butyrate at 30 to 50 mg/kg induces light but sufficient sleep in obtaining a useful scan. Within the group of 24 infants we obtained 14 good results, 8 mild ones and 2 failures. Within the 40 children over eight months of age, 28 procedures were good, 10 children had to undergo more anesthesia during the examination and twice the exploration was impossible.

The authors give their experiences in nurseling and children brain neuroradiology anaesthesia. Sodium gammahydroxybutyrate has been definitively adopted after multiples anaesthesial protocoles for the gaz tomoencephalographic exam, known for its technical risks. The gamma OH gives a perfect cardiac and pulmonary stability in difficult conditions, with normal intracranial pression, even in children anaesthesia with Halothane (0.5%) for complementary analgesic effect or with fractionate injections of dextromoramide. Pneumoencephalography has been releguated in second place by the even of brain computer tomography except some particular indications. But this exam qualified as painless is usually indicated in fragile and deficient childrens. Though the intravenous iodated contrasted substance injection can improve the scan image quality and may induce secondary effects at 2 cm3/kg dose. It's again gamma OH after correct premedication that gives stable, perfect immobility, cardiac and pulmonary stability in an ideal anaesthesia for non ventilated patients. The only critical aspect of this method consists on a prolonged and imprevisible delay to awake so that it cannot be an ambulatory anaesthesial method. Therefore it appears that gamma OH in spite of brain computer tomographic event, is an interesting anaesthesic drug but non definitive in brain neuroradiological exam for childrens.