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The effect of sleep on conscious sedation
B J Sanders1, R H Potter, D R Avery
1Department of Pediatric Dentistry, Indiana University, James Whitcomb Riley Hospital for Children, Indianapolis.
Insights
Ensuring children get adequate preoperative sleep may improve the success of conscious sedation. Older children, specifically those over 36 months, also showed better sedation outcomes in this study.
Area of Science:
- Pediatric Dentistry
- Anesthesiology
- Sedation
Background:
- Conscious sedation is frequently used in pediatric dentistry to manage anxiety and facilitate treatment.
- Optimizing factors that contribute to successful sedation is crucial for patient comfort and procedural efficiency.
Purpose of the Study:
- To investigate the impact of preoperative sleep duration and bedtime routines on the success of conscious sedation in children.
- To determine if children's age influences the outcome of conscious sedation.
Main Methods:
- A study involving 30 healthy children (18-61 months) receiving chloral hydrate, hydroxyzine, and nitrous oxide for dental procedures.
- Parental questionnaires assessed preoperative sleep, diet, and activity.
- Sedation success was operator-ranked (1-4), and data analyzed using Mann-Whitney and Kruskal-Wallis tests.
Main Results:
- Children receiving normal or greater preoperative sleep showed a trend towards higher sedation success (P = .06).
- Children older than 36 months had significantly higher successful sedation rates (P = .02).
- No correlation was found between bedtime, parental perception of tiredness, and sedation success.
Conclusions:
- Adequate preoperative sleep may be a borderline significant factor in achieving successful conscious sedation in children.
- Child's age is a significant factor, with older children (>36 months) experiencing more successful sedations.
- Optimizing sleep and considering age may enhance the conscious sedation experience for children undergoing dental procedures.
Abstract:
This study evaluated the effect of preoperative sleep on the success of conscious sedation. Thirty healthy children between the ages of 18 and 61 months of age were utilized in this study. The children all received chloral hydrate (50-60 mg/kg) and hydroxyzine (15-25 mg) and nitrous oxide (30-50%). Parents were asked to complete a questionnaire which asked several questions about their child's activity the previous day, their diet, and questions that related to their bedtime. The operator ranked the sedations on a scale from 1 to 4 with 1 being good and 4 being poor. The results were then statistically evaluated using the non-parametric Mann-Whitney and Kruskal-Walls tests. The children that received a normal amount of sleep or greater amount of sleep preoperatively had a borderline (P = .06) higher degree of successful sedation. There was no correlation between the child's bedtime (early, normal, late) and the success of sedation. The parent's perception of their child's tiredness could not be correlated with the success of the sedation. The children greater than 36 months of age had a significantly (P = .02) higher degree of successful sedations. The results suggest that a well rested child may experience a more pleasant dental sedation while under chloral hydrate and hydroxyzine conscious sedation and that the child's age at the time of the sedation may affect the outcome of the sedation.