Use of a single dose of 70mg/kg chloral hydrate as a hypnotic in nuclear magnetic resonance. A prospective study of 3132 cases.

OBJECTIVE

To assess the mean time to hypnosis, hemodynamic stability, and incidence of complications associated with the administration of 70mg/kg oral chloral hydrate in children scheduled for magnetic resonance imaging (MRI).

MATERIAL AND

METHODS

Prospective study conducted from January 2000 to January 2020 in which 3132 patients aged between one day and 5 years underwent MRI under anaesthesia in an outpatient setting. The study population was divided into 4 subgroups: A) aged between one and 30 days; B) aged between one month and one year; C) aged between one and 3 years, and D) aged between 3 and 5 years. Study variables were: sex, age, type of examination, mean imaging time, mean time to awakening, heart rate before and after MRI, SatO2, and incidence of complications such as respiratory depression (SatO2 below 90%), agitation during the MRI or on awakening (intense crying lasting more than 2min), prolonged sedation measured on the Steward scale, and nausea and/or vomiting during the MRI, on awakening, or at home.

RESULTS

No notable hemodynamic alterations were observed. The incidence of desaturation was .41%, awakening during the test was .16%, prolonged sedation was 1.08%, and agitated awakening was 1.46%. Nausea and vomiting at the end of the test had an incidence of .73%. The P value in all cases was <.05%.

CONCLUSIONS

Chloral hydrate at a dose of 70mg/kg continues to be suitable in sedation lasting no more than one hour for non-invasive procedures in children, and is associated with adequate haemodynamic stability with practically no side effects.