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.

Citations

• Risk factors for chloral hydrate sedation failure in pediatric patients: a retrospective analysis
  Young-Eun Jang, Jung-Bin Park, Pyoyoon Kang, Sang-Hwan Ji, Eun-Hee Kim, Ji-Hyun Lee, Hee-Soo Kim, Jin-Tae Kim
  Korean Journal of Anesthesiology.2024; 77(5): 526.     CrossRef

PURPOSE
To examine the effects on skin injury, pain, and anxiety when nurses and children simultaneous wash their hands before IV injections.
METHOD
A nonequivalent control group, non-synchronized design study was used with 61 children. For a month and a half, children in the experimental group(30) following hand-washing guidelines, washed their hands with nurses before IV insertion. Anxiety and pain were observed and recorded during IV insertion using the Anxiety Reaction Scale and FACES pain scale. After 48-72 hours on IV therapy with an arm-board, skin condition was checked by a research assistant according to guidelines for assessing skin injury developed by the researcher. t-test, chi-square-test, Pearson correlation, and Kendall's tau b were used to analyze data with the SPSS program.
RESULTS
Children who washed their hands with the nurse before IV insertion showed less pain (p =.021) and skin injury (p <.001) compared to the control group.
CONCLUSION
This finding suggests that simultaneous hand washing by nurse and child before IV injection has a strong effect on skin injury caused by arm-boards used to maintain IV therapy as well as on pain during IV insertion. This program demonstrates an effective intervention to prevent skin injuries in children on IV therapy.