Samali El Mehdi, El Koundi Abdelghafour, Meskine Amine, Balkhi Hicham, Moussaoui Mohammed
Anesthesiology service of Military Teaching Hospital Mohammed V, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Morocco.
Anesthesiology and Intensive Care Department, Military Teaching Hospital Mohammed V, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Morocco.
Afr J Emerg Med. 2025 Sep;15(3):100887. doi: 10.1016/j.afjem.2025.100887. Epub 2025 Jun 25.
Alphachloralose, initially used as a hypnotic and anesthetic, is now restricted to rodenticides. Despite limited medical use, it remains accessible in North Africa, contributing to intentional poisonings. Poisoning primarily presents with neurological and respiratory symptoms, posing a significant public health concern. This study describes the epidemiological, clinical, and therapeutic characteristics of alphachloralose poisoning cases admitted to the adult emergency department of a university hospital in Casablanca, Morocco.
A retrospective study analyzed emergency department records for alphachloralose poisoning cases from October 2022 to June 2023. Poisoning was confirmed based on clinical presentation, witness accounts, and/or biological toxicological evidence. Data on demographics, exposure circumstances, clinical features, interventions, and outcomes were extracted. Severity was evaluated using the Poisoning Severity Score (PSS), grading the severity into five levels from 0 (no symptoms) to 4 (fatal). Hospital stay duration and complications were also assessed.
Some 53 cases were included, with mean age of patients 27 years, and a male-to-female ratio of 0.83. Suicidal ingestion accounted for the vast majority of cases (98 %). Alphachloralose was exclusively ingested in powdered form, as no other formulations are available in Morocco. Neurological and respiratory disturbances were the most common clinical manifestations, with 28 % of cases classified as severe according to the PSS. Gastric lavage was performed in 52.8 % of cases, benzodiazepines were administered in 54 %, and 39.6 % of patients required intubation. The median time to admission to intensive care was 5 h. The average duration of hospitalization was 2.4 ± 1.2 days. Although one fatality occurred, 98 % of cases recovered fully without complications, emphasizing the importance of early and appropriate management.
Alphachloralose poisoning is a significant toxicological concern in North Africa due to its availability and misuse. Severe symptoms are frequent, but early intervention leads to favorable outcomes. Public health measures focusing on regulation and education are essential.
α-氯醛糖最初用作催眠药和麻醉剂，现在仅限于用作杀鼠剂。尽管其医疗用途有限，但在北非仍可获取，这导致了故意中毒事件的发生。中毒主要表现为神经和呼吸系统症状，这对公共卫生构成了重大威胁。本研究描述了摩洛哥卡萨布兰卡一家大学医院成人急诊科收治的α-氯醛糖中毒病例的流行病学、临床和治疗特征。
一项回顾性研究分析了2022年10月至2023年6月期间急诊科α-氯醛糖中毒病例的记录。根据临床表现、证人陈述和/或生物毒理学证据确诊中毒。提取了有关人口统计学、接触情况、临床特征、干预措施和结果的数据。使用中毒严重程度评分（PSS）评估严重程度，将严重程度分为从0（无症状）到4（致命）的五个等级。还评估了住院时间和并发症情况。
共纳入53例病例，患者平均年龄27岁，男女比例为0.83。绝大多数病例（98%）为自杀性摄入。由于摩洛哥没有其他剂型，α-氯醛糖仅以粉末形式被摄入。神经和呼吸紊乱是最常见的临床表现，根据PSS，28%的病例被归类为严重。52.8%的病例进行了洗胃，54%的病例使用了苯二氮䓬类药物，39.6%的患者需要插管。入住重症监护病房的中位时间为5小时。平均住院时间为2.4±1.2天。虽然发生了1例死亡，但98%的病例完全康复且无并发症，这强调了早期和适当管理的重要性。
由于α-氯醛糖的可获取性和滥用，其中毒是北非一个重大的毒理学问题。严重症状很常见，但早期干预可带来良好的结果。侧重于监管和教育的公共卫生措施至关重要。
