Chloral hydrate as a sedating agent for neurodiagnostic procedures in children

Fong, Choong Yi; Lim, Wei Kang; Liu, Limin; Lai, Nai Ming

doi:10.1002/14651858.cd011786.pub3

Cited by 12 publications

(12 citation statements)

References 74 publications

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“…Although the pharmacological mechanism of chloral hydrate is complex and not fully understood, the current results support further testing the potential of these compounds for the treatment of Meth use disorders. Chloral hydrate is a classic drug with a long history of use in the clinic, especially in pediatric testing, The dose we used in the study is the range of clinically permissible dose ( Wilson et al, 2014 ; Mataftsi et al, 2017 ; Fong et al, 2021 ), so its safety can be certified and it is possible to conduct clinical testing, to develop the value of new use of its old drugs. In addition, this study further suggests that some sedative drugs previously used in the clinic may be anti-amphetamines with development potential for controlling the harm of synthetic drugs, especially Meth and other psychostimulants.…”

Section: Discussionmentioning

confidence: 99%

Chloral Hydrate Alters Brain Activation Induced by Methamphetamine-Associated Cue and Prevents Relapse

Jiang

Zhong

et al. 2022

Front. Mol. Neurosci.

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Methamphetamine is a highly addictive drug and its abuse leads to serious health and social problems. Until now, no effective medications are yet available for the treatment of methamphetamine addiction. Our study reveals that chloral hydrate, a clinical sedative drug, suppresses the seeking desire for methamphetamine. After 5 days of continuous administration (subanesthetic dose 50 mg/kg and 100 mg/kg), methamphetamine-seeking behavior of rats was inhibited in the condition place preference and intravenous self-administration tests. Furthermore, chloral hydrate treatment robustly suppressed cue-induced methamphetamine relapse. The whole brain c-fos immunostaining revealed that chloral hydrate treatment suppressed neuronal activity in the rhomboid thalamic nucleus (Rh), dorsal endopiriform nucleus (dEn), and claustrum (Cl) while enhanced zona incerta (ZI) activity during cue-induced methamphetamine relapse. Therefore, chloral hydrate could remodel neural network activity and serve as a potential medicine to treat methamphetamine addiction.

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Section: Discussionmentioning

confidence: 99%

Chloral Hydrate Alters Brain Activation Induced by Methamphetamine-Associated Cue and Prevents Relapse

Jiang

Zhong

et al. 2022

Front. Mol. Neurosci.

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“…Due to the difficulty in cooperating with MRI examinations in the awake state because of the age of the subjects, all subjects were sedated orally with 10% chloral hydrate (0.5 mL/kg, with the maximum dose not exceeding 10 mL) 30 min before the scan. Chloral hydrate sedation is usually used in China before pediatric examinations (Chen et al, 2019; Fong et al, 2021). The chloral hydrate was prescribed by the pediatrician and administered under a strict clinical protocol established by the hospital's radiation sedation committee.…”

Section: Methodsmentioning

confidence: 99%

Abnormal gray matter volume and functional connectivity patterns in social cognition‐related brain regions of young children with autism spectrum disorder

et al. 2023

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Autism spectrum disorder (ASD) is associated with abnormal brain imaging findings, but descriptions thereof are inconsistent. The aim of the present study was to investigate brain abnormalities in young children with ASD using a combination of structural and functional brain magnetic resonance imaging (MRI). Structural and resting-state functional MRI was performed in 67 children with ASD (aged 2-7 years) and 39 age-matched typically developing (TD) controls. Voxel-based morphometry was used to evaluate differences in brain structure between groups. Topologic parameters of the functional brain network were compared by graph theoretic analysis and network connectomes were compared with network-based statistics. A support vector machine (SVM) was used to discriminate between ASD and TD groups. Results demonstrated young children with ASD had increased gray matter volumes (GMVs) in the right medial superior frontal gyrus and left fusiform gyrus compared with the TD group. The ASD group had altered subnetwork connectivity in frontal and temporal lobes and other social cognition-related brain regions. Functional connectivity in the left superior temporal gyrus and left temporal pole of the middle temporal gyrus was positively correlated with adaptability and language developmental quotient (DQ) in children with ASD. The combination of the brain structural and functional features had 86.2% accuracy in discriminating between ASD and TD. The present study shows that young children with ASD have altered GMVs and functional networks in social cognition-related brain regions, which are potential neuroimaging biomarkers for ASD. Lay SummaryThis study explored brain abnormalities in young children with ASD using a combination of structural and functional brain magnetic resonance imaging. Altered GMVs and functional networks in social cognition-related brain regions were found in subjects with ASD compared with TD controls, which are potential neuroimaging biomarkers for ASD.

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“…For some patients, especially infants and young children, the appropriate use of sedatives may be helpful for examination. 4 Commonly used sedatives are chloral hydrate, dexmedetomidine, melatonin, midazolam and so on.…”

Section: Introductionmentioning

confidence: 99%

“…Chloral hydrate is widely used; however, concerns have been raised about its safety and efficacy, especially the potential for adverse reactions, such as vomiting, agitation, sedation-induced hypoxemia, and so forth. [4][5][6] In a study of chloral hydrate used for preechocardiography sedation in 1095 patients, the incidence of adverse events was 8.3%, with an increased risk of serious adverse events in infants below age 6 months. 7 In addition, chloral hydrate caused an increase in the latency and a change in amplitude of all Middle Latency Response components in guinea pigs, and a longer recovery period.…”

Section: Introductionmentioning

confidence: 99%

“…Its role is significant for hearing diagnosis; however, it is challenging for patients to complete the test because they are required to remain quiet throughout the examination to reduce interference, as they are not prone to spontaneous sleep even with priority interventions such as sleep deprivation the day before the examination. For some patients, especially infants and young children, the appropriate use of sedatives may be helpful for examination 4 . Commonly used sedatives are chloral hydrate, dexmedetomidine, melatonin, midazolam and so on.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy and safety of chloral hydrate in auditory brainstem response test: A systematic review and single‐arm meta‐analysis

Liu,

Zhang,

Yao

et al. 2023

Clinical Otolaryngology

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ObjectivesTo evaluate the safety and efficacy of chloral hydrate in auditory brainstem response (ABR) tests.Setting and DesignIn this study, the authors systematically searched both English (Embase, PubMed, and Web of Science) and Chinese (Chinese National Knowledge Infrastructure, Wanfang Data, and VIP Chinese Science) databases. Two authors independently performed data extraction and quality assessment. The pooled sedation failure rate and the pooled incidence of adverse events were calculated via a random‐effects model. Sensitivity and subgroup analyses were performed to explore the sources of heterogeneity, and the PRISMA guideline was followed.ParticipantsPatients with ABR tests receiving chloral hydrate sedation.Main outcome measuresThe pooled sedation failure rate and the pooled incidence of adverse events.ResultsA total of 23 clinical studies were included in the final analysis. The pooled sedation failure rate of patients who received chloral hydrate sedation before ABR examination was 10.0% [95% confidence interval (CI) (6.7%, 15.0%), I2 = 95%, p < .01]. There were significant differences in the prevalence of sedation failure between sample sizes greater than 200 and those less than or equal to 200 (5.6% vs. 19.6%, p < .01) and between the studies that reported sleep deprivation and those that did not report sleep deprivation (7.1% vs. 18.9%, p < .01). The pooled incidence of adverse events was 10.32% [95% CI (5.83%, 14.82%), I2 = 98.1%, p < .01].ConclusionsChloral hydrate has a high rate of sedation failure, adverse events, and potential carcinogenicity. Therefore, replacing its use in ABR tests with safer and more effective sedatives is warranted.

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Chloral hydrate as a sedating agent for neurodiagnostic procedures in children

Cited by 12 publications

References 74 publications

Chloral Hydrate Alters Brain Activation Induced by Methamphetamine-Associated Cue and Prevents Relapse

Chloral Hydrate Alters Brain Activation Induced by Methamphetamine-Associated Cue and Prevents Relapse

Abnormal gray matter volume and functional connectivity patterns in social cognition‐related brain regions of young children with autism spectrum disorder

Efficacy and safety of chloral hydrate in auditory brainstem response test: A systematic review and single‐arm meta‐analysis

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