Lin Yu-Cheng, Ma Juine-Yih
Department of Pediatrics, Far Eastern Memorial Hospital, Taipei, Taiwan.
J Formos Med Assoc. 2006 Mar;105(3):235-7. doi: 10.1016/S0929-6646(09)60311-9.
Chloral hydrate is generally considered to be a safe hypnotic drug, and is commonly used for short-term sedation before diagnostic procedures. Its irritant actions to the mucous membranes are usually limited. We report a rare complication of chloral hydrate overdose in an infant. An 8-month-old male infant became unconscious and required ventilation support after an overdose of chloral hydrate was administered to provide sedation for an ophthalmologic examination. White plaques and sloughing of the oropharyngeal mucosa were observed on the next day. Esophagogastroscopy revealed severe corrosive lesions on the whole esophagus. The child recovered after supportive treatment and his oral intake remained well without dysphagia after 1 year. This report illustrates the potential corrosive effect of chloral hydrate. Strict attention should be paid to the dosing and administration protocol of chloral hydrate in infants. The condition of the oropharyngeal mucosa should be carefully monitored after chloral hydrate administration.
水合氯醛通常被认为是一种安全的催眠药物,常用于诊断程序前的短期镇静。其对粘膜的刺激作用通常有限。我们报告了一例婴儿水合氯醛过量的罕见并发症。一名8个月大的男婴在服用水合氯醛过量以进行眼科检查镇静后失去意识,需要通气支持。第二天观察到口咽粘膜出现白色斑块和脱落。食管胃镜检查显示整个食管有严重的腐蚀性病变。患儿经支持治疗后康复,1年后口服摄入良好,无吞咽困难。本报告说明了水合氯醛的潜在腐蚀作用。应严格注意婴儿水合氯醛的给药剂量和方案。服用水合氯醛后应仔细监测口咽粘膜状况。