Sleep deprivation for pediatric sedated procedures: not worth the effort

Objective. Sleep deprivation is commonly used to enhance the effectiveness of pediatric sedation and to decrease sedation failures. We reviewed our sedation database to evaluate the efficacy of sleep deprivation. Methods. The entire pediatric sedation unit database (n = 5640) was reviewed retrospectively. Patients without complete data sets were excluded. The remaining patients were separated into 2 groups: 3272 patients who underwent noninvasive procedures and 1210 who underwent invasive procedures. A subgroup of noninvasive procedure patients Results. In the noninvasive procedure group, the sedation failure rate was 5.7% for the sleep-deprived patients and 5.6% for the non-sleep-deprived patients, whereas the sedation failure rate for children Conclusions. Sleep deprivation had no effect in reducing the pediatric sedation failure rate. The patients having noninvasive procedures who were sleep deprived required significantly more nursing care hours than their non-sleep-deprived counterparts. Routine use of sleep deprivation for pediatric sedation should be critically reevaluated. Pediatrics 2004;113:1204-1208; sleep deprivation, pediatric sedation, sedation failure. ABBREVIATIONS. EEG, electroencephalography; MRI, magnetic resonance imaging; CT, computed tomography.
Sedation is frequently required to facilitate diagnostic and therapeutic procedures in children. When sedation is performed, the focus is twofold: safety and efficacy. The American Academy of Pediatrics, the American [...]