Overdose of chloral derivatives in children

Two children developed profound coma with generalized flaccidity as a result of overdoses of chloral and one of its derivatives. One of them, a preterm infant who received 500 mg/kg of Triclofos, also developed severe hypothermia with mild hypotension and was in grade 2 coma with absence of primitive and deep tendon reflexes. Recovery was slow with primitive reflexes appearing last. The second case also developed grade 2 coma after a dose of 65 mg/kg of chloral hydrate. Treatment included continuous monitoring and i.v. fluids and consciousness was regained within a few days, without any neurologic sequellae. The benign course of overdose with choral hydrate and its derivatives suggests their relative safety when used for hypnotic/sedative effects.