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Effects of Sleep Deprivation on the Sedation of Pediatric Patients Undergoing MRI Examinations
Authors:Eun-Hoe Goo  Tac-Han Jung  Dae-Cheol Kweon  Kyung-Rae Dong  Chong-Hwan Choe
Institution:1. Department of Radiology , Seoul National University Hospital , Republic of Korea;2. Department of Physics , Soonchunhyang University , Republic of Korea;3. Department of Radiology , Seoul National University Hospital , Republic of Korea;4. Department of Radiologic Science , Shin Heung College University , Republic of Korea;5. Department of Radiological Technology , Gwangju Health College University , Republic of Korea;6. Department of Nuclear Engineering , Chosun University , Republic of Korea;7. Department of White Memorial Medical Center , Los Angeles, CA, USA
Abstract:Sedation is an essential factor for pediatric magnetic resonance imaging (MRI) procedure. A long-term failure of sedation has a detrimental effect on a 1 day test plan. Given this background, this study examined the effects of sedation using a sleep deprivation method in pediatric patients scheduled to undergo an MRI examination. The current study examined 54 patients (36 boys and 18 girls) with diseases, such as epilepsy, brain tumor, development delay, mental retardation, and cerebral infarction, who were treated at our medical institution from December 2009 to March 2010. The patients were classified into two groups: group A (n = 27) with sleep deprivation, and group B (n = 27) without sleep deprivation. The mean age of these patients was 4.2 years. Comparative analysis of groups A and B was performed to assess the success rate of pediatric sedation, the time elapsed until complete sedation had been achieved, and the frequency at which patients took Pocral syrup (chloral hydrate). In group A, patients were allowed to start sleep 1 hr later and were woken 1 hr earlier than their mean sleep time. According to this pretreatment, the rate of successful sedation, frequency of the administration of Pocral syrup, and the time elapsed until deep sedation had been achieved were measured. In group A, the rate of successful sedation was 100%, the mean time elapsed until deep sedation had been achieved was 23 min, and the mean frequency of Pocral syrup administration was 1.2 times. In addition, the proportions of patients who had achieved successful sedation after one-time use and two-time use of Pocral syrup were 77.8% and 22.2%, respectively. In group B, successful sedation was achieved in 89%, and the mean time elapsed until deep sedation was 39 min. The mean frequency of Pocral syrup administration was 1.5 times. The proportions of patients who had achieved successful sedation after one-time use and two-time use of Pocral syrup were 51.9% and 48.12%, respectively. The statistical significance was tested using a nonparametric analysis, Mann–Whitney U Test (p < 0.05). Other studies have reported that sleep deprivation had no significant effects. An actual comparison of the sleep-deprived and other patients showed that sleep deprivation affected the rate of successful sedation, the frequency of Pocral syrup administration, and the time elapsed until the patients were sedated. The rate of successful sedation was significantly higher in group A than in group B. The time elapsed until deep sedation had been achieved was also significantly shorter in group A than in group B. In addition, the frequency of Pocral syrup administration (administration dose) was significantly lower in group A than in group B. In conclusion, sleep deprivation increases the effectiveness of pediatric sedation in an MRI examination of pediatric patients and might assist in performing an MRI examination more efficiently in pediatric patients.
Keywords:MRI  Pocral  sedation  sleep deprivation
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