Chloral Hydrate Sedation - Information for parents and caregivers

About Chloral hydrate

It’s important that your child does not eat (including breast / formula milk) 4 hours prior to the sedation. This enables the medication to be effective and reduces the risk of vomit being inhaled. Chloral hydrate tastes like mouthwash, it’s a strong flavour that most children don’t like. It’s common for children to retch / vomit during the administration of chloral hydrate. It can only be given orally.
Please keep your child close to you after the medication is given. A dark quiet room enables the sedation to be successful. It can take 15 - 45 mins to take effect (usually quicker for under 1 yr and longer for over 1 yrs). The older the child, the increased likeliness of them becoming irritable as the medication takes effect. At times they may need containment for safety. As the medication reaches its desired effect, you will notice that your child becomes floppy and their head will need supporting. This will resolve as the medication wears off.
The following information details some of the common temporary post sedation symptoms that parents may notice regarding their child.

Prolonged sleepiness

Approximately half of all children will be back to their normal selves by 2 hours after the chloral hydrate was given. Some are sleepy for a longer period, most resuming normal activities within 4 - 8 hours. A few may take even longer. Children may go to sleep again later in the day. Check on your child's sleeping pattern when they have their next sleep. If their sleeping seems unusually heavy or strange then wake them up gently. They can then go back to sleep.

Unsteadiness with walking, crawling or sitting

This is very common, and is more of a problem for larger, older and mobile children.
Supervise your child during this time for all activities such as toileting, playroom, physical activities and bathing. They may not be aware their limits have changed so a close eye on them is recommended.

Hyperactivity and irritability

Your child may behave slightly differently, easily frustrated, temper tantrums or more active than usual, this is normal. Distraction can be helpful in managing this. By the next day the sedation effects will have worn off and they should be back to their normal selves.

Gastro-Intestinal Problems

Occasionally they may vomit later in the day. Some children also temporarily have a reduced appetite.
We recommend that children sleep for 45 mins – 1 hour post chloral and then are offered something to eat and drink .

Parents should be aware that the drug can take some time to wear off. IF you are concerned about your child in the hours after they have received chloral sedation please speak with the nurse caring for your child.