Side Effects of chloral hydrate: A Synthesis of Findings from 28 Studies

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Original Abstract of the Article

Main Research Findings

Chloral hydrate is a medication that has been widely used as a sedative for children undergoing various medical procedures such as MRI scans and EEGs. 28 , 13 , 21 . Studies have shown that chloral hydrate can effectively sedate children, but it can also cause several side effects.

Reasons for Side Effects

The side effects of chloral hydrate are thought to be related to its pharmacological action and metabolic pathways. Chloral hydrate acts on the central nervous system to induce sleep or sedation. However, when chloral hydrate is metabolized in the liver, it produces a metabolite called trichloroethanol, which can accumulate in the body and cause side effects.

Common Side Effects

Gastrointestinal Side Effects

One of the most common side effects of chloral hydrate is gastrointestinal problems. 2 , 21 . Symptoms like nausea, vomiting, and abdominal pain can occur. This is thought to be due to chloral hydrate irritating the stomach lining. If you experience any gastrointestinal symptoms after taking chloral hydrate, consult a doctor.

Nervous System Side Effects

Chloral hydrate can also affect the nervous system. 2 . It can cause symptoms such as drowsiness, dizziness, confusion, and hallucinations. Chloral hydrate is particularly risky for older adults and those with impaired liver function, increasing their risk of nervous system side effects. If you experience any nervous system symptoms after taking chloral hydrate, consult a doctor.

Respiratory Side Effects

Chloral hydrate can affect the respiratory system as well. 2 . It can cause shallow breathing or even breathing cessation. Individuals with respiratory conditions, especially older adults, are more susceptible to respiratory side effects from chloral hydrate. Seek immediate medical attention if you experience any respiratory symptoms after taking chloral hydrate.

Cardiovascular Side Effects

Chloral hydrate can affect the cardiovascular system. 2 . It can cause a slowed heart rate and a decrease in blood pressure. Individuals with heart disease have an increased risk of experiencing cardiovascular side effects from chloral hydrate. If you experience any cardiovascular symptoms after taking chloral hydrate, consult a doctor immediately.

Other

Chloral hydrate can also trigger allergic reactions. Seek immediate medical attention if you experience an allergic reaction such as rash, itching, or difficulty breathing after taking chloral hydrate.

Side Effects Management

Gastrointestinal Side Effects

To reduce stomach irritation, it's recommended to take chloral hydrate with food. 2 . Staying adequately hydrated can also help prevent gastrointestinal side effects.

Nervous System Side Effects

Refrain from driving or operating hazardous machinery after taking chloral hydrate. 2 . Chloral hydrate can cause drowsiness, potentially increasing the risk of accidents or injuries.

Respiratory Side Effects

Monitor your breathing carefully while taking chloral hydrate. 2 . Consult a doctor immediately if you experience shallow breathing or breathing cessation.

Cardiovascular Side Effects

If you have heart disease, consult a doctor before taking chloral hydrate. 2 . Chloral hydrate can potentially worsen heart conditions.

Other

Inform your doctor about any allergies before taking chloral hydrate. Chloral hydrate can trigger allergic reactions.

Comparison Between Studies

Similarities Between Studies

Multiple studies have demonstrated the effectiveness of chloral hydrate as a sedative for children undergoing various medical procedures. 28 , 13 , 21 . However, these studies also consistently report the potential for side effects such as nausea, vomiting, and drowsiness.

Differences Between Studies

The effectiveness and side effects of chloral hydrate can vary based on numerous factors including dosage, age, and overall health status. 21 . For instance, a study found a correlation between higher chloral hydrate doses and increased sedation, but also a heightened risk of side effects. 21 .

Cautions for Real-Life Applications

It is crucial that chloral hydrate is used under the supervision of a doctor as a sedative for children undergoing medical procedures. 21 . Avoid self-administering chloral hydrate due to the potential for side effects.

Current Research Limitations

Further research is needed to fully understand the long-term safety and effectiveness of chloral hydrate. 2 . Research into safer methods to minimize side effects and the development of alternative safe sedatives are crucial.

Future Research Directions

Research efforts are needed to develop safer methods for mitigating the side effects of chloral hydrate and explore alternative, safe sedatives. 2 . Moreover, additional studies are required to investigate the long-term safety and effectiveness of chloral hydrate.

Conclusion

It's essential to use chloral hydrate under the guidance of a doctor as a sedative for children undergoing medical procedures. 21 . Due to the possibility of side effects, avoid self-medicating with chloral hydrate. Consult your doctor if you experience any side effects related to chloral hydrate.

Keywords
Benefit Keywords
Improved procedural sedation
Increased sedation
1
Hypnotic
Sedative
2
Effective sedation
Hemodynamic stability
3
Delirium treatment
4
Pediatric sedation
Safe and effective
5
Sedation for CT scan
6
Effective examination
Safe sedation
8
Pediatric sedation
Reduced vomiting
9
Depression treatment
Epilepsy treatment
10
Spasticity treatment
11
Minimize irritancy
12
Effective sedation
Hemodynamic stability
13
Sedation without IOP changes
14
Anxiety control
15
sedation
seizure treatment
16
Painless procedures
17
EEG recording
Melatonin sedation
18
EEG improvement
Sleep induction
19
Neuropathy recovery
20
Sedation for MRI
21
Analgesia
Sedation
22
Ovarian repair
24
Less sedative effect
26
Schizophrenia treatment
27
Effective for sleep induction
28
Risk Keywords
Apnea
Bradycardic events
Decreased oral intake
1
Carcinogenicity
Cardiovascular issues
Dermatologic issues
Digestive issues
Genotoxicity
Intoxication risk
Neuropsychiatric issues
Ophthalmologic issues
2
Agitated awakening
Awakening during test
Desaturation
Nausea and vomiting
Prolonged sedation
3
Anticholinergic effects
Increased mortality
Orthostatic effects
4
Inconsistent intake
Minor side effects
5
Adverse drug responses
7
Adverse events in patients needing a top-up dose
Adverse events in patients over 15 kg
Failure in patients needing a top-up dose
Failure in patients over 15 kg
Oxygen desaturation
Paradoxical reaction
Vomiting
8
Anesthesia side effects
11
Agitated awakening
Desaturation
13
Resistance to swallowing
14
cardiac arrest
respiratory depression
16
Deaths in infants with heart disease
17
Sedative drugs
Sleep deprivation
18
Disulfiram neuropathy
Dose-dependent neuropathy
20
Nausea
Stomach pain
Vomiting
21
Sleep disorders
23
Chemotherapy-induced POF
24
Side effects of anesthetics
25
Prominent side effects on sleep EEG
28
Literature analysis of 28 papers
Positive Content
20
Neutral Content
1
Negative Content
7
Article Type
3
0
0
6
28
1.

Pharmacodynamics of chloral hydrate in former preterm infants.

Author: AllegaertKarel, DanielsHans, NaulaersGunnar, TibboelDick, DevliegerHugo

Improved procedural sedation
Increased sedation
Apnea
Bradycardic events
Decreased oral intake

Chloral hydrate administration for procedural sedation in former preterm infants at term post-conception age resulted in increased sedation but also a significant increase in bradycardic events.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

2.

[Chloral hydrate: a hypnotic best forgotten?].

Author: GauillardJ, CherefS, VacherontrystramM N, MartinJ C

Hypnotic
Sedative
Carcinogenicity
Cardiovascular issues
Dermatologic issues
Digestive issues
Genotoxicity
Intoxication risk
Neuropsychiatric issues
Ophthalmologic issues

Chloral hydrate is an old sedative that has been used for centuries. It is now known to be potentially dangerous and there is concern about its genotoxicity and carcinogenicity. The review discusses its pharmacology, side effects, and contraindications, concluding that its use for insomnia is no longer justified.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : French

3.

Use of a single dose of 70mg/kg chloral hydrate as a hypnotic in nuclear magnetic resonance. A prospective study of 3,132 cases.

Author: Sistac BallarínJ M, Solé GuixesJ, Groizard BotellaM J, Sistac PalacínJ M

Effective sedation
Hemodynamic stability
Agitated awakening
Awakening during test
Desaturation
Nausea and vomiting
Prolonged sedation

Oral chloral hydrate at a dose of 70 mg/kg was found to be suitable for sedation in children undergoing magnetic resonance imaging (MRI), with a mean time to hypnosis of 11.2 minutes and minimal hemodynamic changes. The incidence of complications was low.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

4.

[Psychopharmalogical treatment of delirium in the elderly].

Author: DrachLutz M

Delirium treatment
Anticholinergic effects
Increased mortality
Orthostatic effects

Delirium is a common condition in hospitalized elderly patients, and treatment focuses on addressing the underlying medical cause. While antipsychotics may be used to manage symptoms, caution is advised due to potential risks.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : German

5.

Chloral hydrate for pediatric ophthalmologic examinations.

Author: NoskeW, PapadopoulosG

Pediatric sedation
Safe and effective
Inconsistent intake
Minor side effects

Oral chloral hydrate is safe and effective for painless pediatric ophthalmologic examinations and may be more reliable than rectal chloral hydrate.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

6.

Oral chloral hydrate vs. intranasal midazolam for sedation during computerized tomography.

Author: FallahRazieh, NakhaeiMohammad Hosein Ataee, BehdadShekofah, MoghaddamReza Nafisi, ShamszadehAli

Sedation for CT scan

This study compared the efficacy and safety of oral chloral hydrate and intranasal midazolam for sedation in children undergoing computerized tomography (CT) scan of the brain. Oral chloral hydrate was found to be more effective and safe for sedation than intranasal midazolam.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

Medication use in childhood dystonia.

Author: LumsdenDaniel E, KaminskaMargaret, TomlinStephen, LinJean-Pierre

Adverse drug responses

This study reviewed medications used to treat childhood dystonia and determined the prevalence of adverse drug responses (ADRs) resulting in discontinuation of drug use. The study also identified clinical risk factors for ADRs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

8.

Utilisation of an outpatient sedation unit in paediatric ophthalmology: safety and effectiveness of chloral hydrate in 1509 sedation episodes.

Author: WestStephanie K, GriffithsBeverley, ShariffYasmin, StephensDerek, MireskandariKamiar

Effective examination
Safe sedation
Adverse events in patients needing a top-up dose
Adverse events in patients over 15 kg
Failure in patients needing a top-up dose
Failure in patients over 15 kg
Oxygen desaturation
Paradoxical reaction
Vomiting

Chloral hydrate sedation allows detailed examination and investigations in the majority of children with few side effects. Patients over 15 kg and need for a top up dose are risk factors for failure and adverse events.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

10.

Novel attempts to optimize vagus nerve stimulation parameters on serotonin neuronal firing activity in the rat brain.

Author: MantaStella, El MansariMostafa, BlierPierre

Depression treatment
Epilepsy treatment

Vagus nerve stimulation (VNS) is used for treatment-resistant epilepsy and depression. VNS increases the firing rate of NE and 5-HT neurons.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

12.

A pathophysiological study of abdominal organs following intraperitoneal injections of chloral hydrate in rats: comparison between two anaesthesia protocols.

Author: VachonP, FaubertS, BlaisD, ComtoisA, BienvenuJ G

Minimize irritancy

This study minimized the side effects of chloral hydrate (CH) on abdominal organs by using lower concentrations while keeping the same anaesthetic dose (400 mg/kg).

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

14.

Effect of oral chloral hydrate sedation on the intraocular pressure measurement.

Author: JaafarM S, KaziG A

Sedation without IOP changes
Resistance to swallowing

The study investigated the effect of oral chloral hydrate on intraocular pressure (IOP) in children under 6 years old. The high-dose protocol effectively sedated the children without significantly altering IOP levels in both normal and glaucomatous eyes.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

15.

A comparative study on the sedative effect of oral midazolam and oral chloral hydrate medication in lumbar puncture.

Author: DerakhshanfarHojjat, KordiMona Modanloo, AminiAfshin, ShojaheeMajid

Anxiety control

This study aimed to reduce children's anxiety before and during lumbar puncture using oral midazolam and oral chloral hydrate, comparing their efficacy and side effects.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

16.

Midazolam: a review of therapeutic uses and toxicity.

Author: NordtS P, ClarkR F

sedation
seizure treatment
cardiac arrest
respiratory depression

Midazolam, a benzodiazepine, is a safe and effective agent for sedation in the emergency department. It has a rapid onset of action and can be administered via various routes. Potential adverse effects include respiratory depression, particularly when used with opioids.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

18.

Melatonin versus chloral hydrate on sleep induction for recording electroencephalography in children: a randomized clinical trial.

Author: FazliBahareh, HosseiniSeyed-Ahmad, BehnampourNasser, LangariAlale, Habibi-KoolaeeMahdi

EEG recording
Melatonin sedation
Sedative drugs
Sleep deprivation

Melatonin was as effective as chloral hydrate in inducing sedation for EEG recording in children. However, melatonin had a shorter recovery time and no side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

19.

[Comparison between the EEG of natural sleep and the induced by chloral hydrate in relation to paroxysmal changes and baseline rythm].

Author: CastroC B, ChistéM A, VizioliJ F, CórdovaN M, OhlweilerL, LagoI S, CarvalhoW N, KliemannF, RottaN T

EEG improvement
Sleep induction

Chloral hydrate is an effective sleep aid for epileptic children with minimal side effects. It improves sleep patterns and reduces seizure activity.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : Portuguese

20.

Disulfiram neuropathy: a review (1971-1988) and report of a case.

Author: FrisoniG B, Di MondaV

Neuropathy recovery
Disulfiram neuropathy
Dose-dependent neuropathy

Disulfiram neuropathy is a dose-dependent phenomenon, with a higher incidence and severity at higher doses. Recovery depends on the initial degree of impairment, and early diagnosis is important.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

22.

[Sedation and analgesia in childhood].

Author: SchwarzU, BänzigerO, GerberA

Analgesia
Sedation

Sedation should be considered for any child who may be frightened by an intervention. Midazolam and chloral hydrate are the preferred sedatives. Any physician sedating a child must be aware of potential side effects and countermeasures.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : German

25.

Anesthetics inhibit high-affinity states of dopamine D2 and other G-linked receptors.

Author: SeemanPhilip, KapurShitij

Side effects of anesthetics

This study showed that clinical concentrations of anesthetics inhibited the high-affinity states of several G-protein-linked receptors, which may underlie general anesthesia and explain some of the side effects of anesthetics. Subanesthetic concentrations of some anesthetics stimulated the same receptors, which may contribute to the excitement phase seen with subanesthetic doses.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

27.

Ritanserin, a 5-HT2A/2C antagonist, reverses direct dopamine agonist-induced inhibition of midbrain dopamine neurons.

Author: ShiW X, NathanielP, BunneyB S

Schizophrenia treatment

Ritanserin (RIT), a 5-HT2A/2C receptor antagonist, may act on dopamine (DA) autoreceptors directly as a DA antagonist.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

28.

Chloral hydrate and/or hydroxyzine for sedation in pediatric EEG recording.

Author: BektasOmer, ArıcaBüsra, TeberSerap, YılmazArzu, ZeybekHediye, KaymakSelda, DedaGülhis

Effective for sleep induction
Prominent side effects on sleep EEG

Chloral hydrate (CH) and hydroxyzine are equally effective for sleep induction, but CH has more prominent side effects on the sleep EEG.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

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