Child Health Nursing Research

Korean Academy of Child Health Nursing (한국아동간호학회)
권호 표지
DOI QR코드

DOI QR Code

Correlation between the actual sleep time 24 hours prior to an examination and the time to achieve chloral hydrate sedation in pediatric patients in South Korea: a prospective cohort study

  • Park, Mijung (Pediatric Ward, The Catholic University of Korea, Seoul St. Mary's Hospital) ;
  • Um, Ji (Pediatric Ward, The Catholic University of Korea, Seoul St. Mary's Hospital) ;
  • Kim, So Hyun (Pediatric Ward, The Catholic University of Korea, Seoul St. Mary's Hospital) ;
  • Yoon, Jiseon (Pediatric Ward, The Catholic University of Korea, Seoul St. Mary's Hospital) ;
  • Lee, Yeonjae (Pediatric Ward, The Catholic University of Korea, Seoul St. Mary's Hospital) ;
  • Kwon, Jiyeong (Pediatric Ward, The Catholic University of Korea, Seoul St. Mary's Hospital) ;
  • Baek, Seonhee (Pediatric Ward, The Catholic University of Korea, Seoul St. Mary's Hospital) ;
  • Kim, Dong Yeon (Nursing Innovation Unit, The Catholic University of Korea, Seoul St. Mary's Hospital)
  • Received : 2022.10.11
  • Accepted : 2022.12.23
  • Published : 2023.01.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: This study investigated correlations between the actual sleep time 24 hours prior to an examination and the time to achieve chloral hydrate sedation in pediatric patients. Methods: With parental consent, 84 children who were placed under moderate or deep sedation with chloral hydrate for examinations from November 19, 2020 to July 9, 2022 were recruited. Results: Patients' average age was 19.9 months. Pediatric neurology patients and those who underwent electroencephalography took significantly longer to achieve sedation with chloral hydrate. There was a negative correlation between the time to achieve sedation and actual sleep time within 24 hours prior to the examination. Positive correlations were found between the actual sleep time 24 hours prior to the examination and the second dose per weight, as well as between the sedation recovery time and awake hours before the examination. Conclusion: Sleep restriction is not an effective adjuvant therapy for chloral hydrate sedation in children, and sedation effects vary according to pediatric patients' characteristics. Therefore, it would be possible to reduce the unnecessary efforts of caregivers who restrict children's sleep for examinations. It is more important to educate parents about safe sedation than about sleep restriction.

Keywords

Acknowledgement

This study was supported by the research fund of Seoul St. Mary's Hospital, The Catholic University of Korea.

References

  1. Kim NY, Ju HO, Park SY. Performance and knowledge of nurses on the practice of pediatric sedation. Journal of the Korean Society of Maternal and Child Health. 2021;25(4):260-268. https://doi.org/10.21896/jksmch.2021.25.4.260
  2. Yoo YC. Issues in procedural sedation outside the operating theater: characteristics and safety of commonly used sedatives and analgesics. Journal of the Korean Medical Association. 2013;56(4):285-291. https://doi.org/10.5124/jkma.2013.56.4.285
  3. Kim DK. Procedural sedation and analgesia in pediatric emergency department. Pediatric Emergency Medicine Journal. 2018;5(2):31-37. https://doi.org/10.22470/pemj.2018.00290
  4. Bae JA, Choi YH, Kim AJ, Lee SH. Administration and efficiency comparison of chloral hydrate during pediatric sedation. Journal of the Korean Society of Clinical Toxicology. 2016;14(1):9-15. https://doi.org/10.22537/jksct.2016.14.1.9
  5. Dong SZ, Zhu M, Bulas D. Techniques for minimizing sedation in pediatric MRI. Journal of Magnetic Resonance Imaging. 2019;50(4):1047-1054. https://doi.org/10.1002/jmri.26703
  6. Vinson AE, Peyton J, Kordun A, Staffa SJ, Cravero J. Trends in pediatric MRI sedation/anesthesia at a tertiary medical center over time. Paediatric Anaesthesia. 2021;31(9):953-961. https://doi.org/10.1111/pan.14225
  7. Bracken J, Heaslip I, Ryan S. Chloral hydrate sedation in radiology: retrospective audit of reduced dose. Pediatric Radiology. 2012;42(3):349-354. https://doi.org/10.1007/s00247-011-2279-9
  8. Jung SM. Drug selection for sedation and general anesthesia in children undergoing ambulatory magnetic resonance imaging. Yeungnam University Journal of Medicine. 2020;37(3):159-168. https://doi.org/10.12701/yujm.2020.00171
  9. Song JH. Procedural sedation and analgesia in children. Journal of the Korean Medical Association. 2013;56(4):271-278. https://doi.org/10.5124/jkma.2013.56.4.271
  10. Chen ML, Chen Q, Xu F, Zhang JX, Su XY, Tu XZ. Safety and efficacy of chloral hydrate for conscious sedation of infants in the pediatric cardiovascular intensive care unit. Medicine. 2017;96(1):e5842. https://doi.org/10.1097/MD.0000000000005842
  11. Maeng YJ, Oh SH. An effect of sleeping hours prior to procedure on chloral hydrate sedation for pediatric dental patient. Journal of the Korean Academy of Pedtatric Dentistry. 2011;38(4):355-361. https://doi.org/10.5933/JKAPD.2011.38.4.355
  12. Scherrer PD, Mallory MD, Cravero JP, Lowrie L, Hertzog JH, Berkenbosch JW; Pediatric Sedation Research Consortium. The impact of obesity on pediatric procedural sedation-related outcomes: results from the Pediatric Sedation Research Consortium. Paediatric Anaesthesia. 2015;25(7):689-697. https://doi.org/10.1111/pan.12627
  13. Spielman AJ, Saskin P, Thorpy MJ. Treatment of chronic insomnia by restriction of time in bed. Sleep. 1987;10(1):45-56.
  14. Choi SJ, Kim KS. The effects of sleep restriction-emphasized cognitive behavioral therapy for insomnia on sleep with chronic insomniacs: a preliminary study. Journal of Korean Sleep Research Society. 2010;7(2):49-56. https://doi.org/10.13078/jksrs.10009
  15. Kimiya T, Sekiguchi S, Yagihashi T, Arai M, Takahashi H, Takahashi T. Sedation protocol with fasting and shorter sleep leads to magnetic resonance imaging success. Pediatrics International. 2017; 59(10):1087-1090. https://doi.org/10.1111/ped.13371
  16. Jang CH, Kim SH, Oh DH. Cognitive behavioral therapy of insomnia. Hanyang Medical Reviews. 2013;33(4):210-215. https://doi.org/10.7599/hmr.2013.33.4.210
  17. Jang HY, Jung JH, Kyong YY, Kim KH, Kim DK, Kim MR, et al. Korean guidelines for pediatric procedural sedation and analgesia. Journal of The Korean Society of Emergency Medicine. 2012;23(3):303-314.
  18. Ong HT, Lim KJ, Low PC, Low PS. Simple instructions for partial sleep deprivation prior to pediatric EEG reduces the need for sedation. Clinical Neurophysiology. 2004;115(4):951-955. https://doi.org/10.1016/j.clinph.2003.11.012
  19. Alix JJP, Kandler RH, Pang C, Stavroulakis T, Catania S. Sleep deprivation and melatonin for inducing sleep in paediatric electroencephalography: a prospective multicentre service evaluation. Developmental Medicine and Child Neurology. 2019;61(2):181-185. https://doi.org/10.1111/dmcn.13973
  20. Volpe AD, Lucia A, Pirozzi C, Pastore V. Comparative study between the use of melatonin and A solution with melatonin, tryptophan, and vitamin B6 as an inducer of spontaneous sleep in children during an auditory response test: an alternative to commonly used sedative drugs. The Journal of International Advanced Otology. 2017;13(1):69-73. https://doi.org/10.5152/iao.2017.3054
  21. Cui Y, Guo L, Mu Q, Cheng Q, Kang L, He Y, et al. Sleep deprivation did not enhance the success rate of chloral hydrate sedation for non-invasive procedural sedation in pediatric patients. PLoS One. 2021;16(1):e0245338. https://doi.org/10.1371/journal.pone.0245338
  22. Sury MR, Harker H, Begent J, Chong WK. The management of infants and children for painless imaging. Clinical Radiology. 2005; 60(7):731-741. https://doi.org/10.1016/j.crad.2005.02.014
  23. Edwards AD, Arthurs OJ. Paediatric MRI under sedation: is it necessary? What is the evidence for the alternatives? Pediatric Radiology. 2011;41(11):1353-1364. https://doi.org/10.1007/s00247-011-2147-7
  24. Von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP; STROBE Initiative. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. PLoS Medicine. 2007;4(10):e296. https://doi.org/10.1371/journal.pmed.0040296
  25. Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behavior Research Methods. 2009;41(4):1149-1160. https://doi.org/10.3758/BRM.41.4.1149
  26. Chernik DA, Gillings D, Laine H, Hendler J, Silver JM, Davidson AB, et al. Validity and reliability of the observer's assessment of alertness/sedation scale: study with intravenous midazolam. Journal of Clinical Psychopharmacology. 1990;10(4):244-251.
  27. Aldrete JA. The post-anesthesia recovery score revisited. Journal of Clinical Anesthesia. 1995;7(1):89-91. https://doi.org/10.1016/0952-8180(94)00001-k
  28. Brown V, Haak N, Egel RT. Technical tips: age-specific sleep deprivation guidelines. American Journal of Electroneurodiagnostic Technology. 1997;37(3):231-235. https://doi.org/10.1080/1086508X.1997.11079191
  29. Seo BK, Kim A, Jung HM, Kim AJ, Han SB. Comparison of sedation outcome according to the dose of chloral hydrate in children requiring laceration repair. Pediatric Emergency Medicine Journal. 2017;4(2):92-96. https://doi.org/10.22470/pemj.2017.00024
  30. Seo MH, Park S. Awareness, nursing needs, and nursing satisfaction on conscious sedation as a pretreatment for diagnostic tests in the guardians of hospitalized children. Journal of the Korea Convergence Society. 2021;12(12):573-581. https://doi.org/10.15207/JKCS.2021.12.12.573
  31. Choi YS, Son YJ, Song ES, Cho YK, Kim YO, Kim CJ, et al. Effect of chloral hydrate used for pediatric sedation. Journal of the Korean Child Neurology Society. 2008;16(1):78-85.
  32. Boyer RS. Sedation in pediatric neuroimaging: the science and the art. AJNR American Journal of Neuroradiology. 1992;13(2):777-783.