Chloral hydrate in pediatric magnetic resonance imaging: evaluation of a 10-year sedation experience administered by radiologists

• Published in: Pediatric radiology 2015-01, Vol.45 (1), p.108-114
• Main Authors: Delgado, Jorge, Toro, Rodrigo, Rascovsky, Simon, Arango, Andres, Angel, Gabriel J., Calvo, Victor, Delgado, Jorge A.
• Format: Article
• Language: English
• Subjects: Age Distribution; Akathisia, Drug-Induced - epidemiology; Akathisia, Drug-Induced - etiology; Child; Chloral Hydrate - administration & dosage; Chloral Hydrate - adverse effects; Colombia - epidemiology; Deep Sedation - adverse effects; Deep Sedation - statistics & numerical data; Dose-Response Relationship, Drug; Female; Humans; Hypnotics and Sedatives; Imaging; Incidence; Infant; Infant, Newborn; Longitudinal Studies; Magnetic Resonance Imaging - statistics & numerical data; Male; Medicine; Medicine & Public Health; Neuroradiology; Nuclear Medicine; Oncology; Original Article; Pediatrics; Radiology; Respiration Disorders - chemically induced; Respiration Disorders - epidemiology; Risk Factors; Treatment Outcome; Ultrasound; Vomiting - chemically induced; Vomiting - epidemiology
• ISSN: 0301-0449; 1432-1998
• DOI: 10.1007/s00247-014-3091-0

Background Chloral hydrate is a sedative that has been used for magnetic resonance imaging (MRI). Objective To evaluate the use, effectiveness and safety of chloral hydrate administered by radiologists for the sedation of children who require MRI procedures. Materials and methods We retrospectively reviewed the clinical charts for all patients ages 0 – 10 years old who underwent sedation with chloral hydrate for MRI from January 2000 to December 2010. Demographic factors, dose information, indication for MRI, therapeutic failures and adverse reactions to the drug were reviewed. Results One thousand, seven hundred and three children (946 males, 757 females) with a median age of 2.5 years (range: 4 days – 9.91 years) received chloral hydrate. Moderate to deep sedation was achieved in 1,618/1,703 (95%) of the patients, 35/1,703 (2.1%) of the patients failed to achieve moderate to deep sedation, and 47/1,703 (2.8%) of the patients woke up during MRI examination. Adverse reactions were present in 31/1,703 (1.8%) of the patients. Three severe adverse reactions occurred (0.18%). A single dose of chloral hydrate (40–60 mg/kg) was administered to 1,477/1,703 patients (86.7%). An additional dose of chloral hydrate (10–20 mg/kg), given 15 min after the first dose or when the patient woke up during the MRI examination, was required in 226/1,703 patients (13.3%). The likelihood of requiring an additional dose in children older than 2 years was 2.2 times the likelihood compared to children younger than 2 years (OR = 2.2 [95%CI: 1.6–3.0]). The use of a reduced dose (