Cui Yu, Guo Langtao, Xu Li, Mu Qixia, Wu Qunying, Kang Lu, Chen Qin, He Yani, Liu Hong
Department of Anesthesiology, Chengdu Women's & Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610091, China.
J Clin Med. 2023 Feb 3;12(3):1245. doi: 10.3390/jcm12031245.
Physiological processes influencing a drugs' efficacy change substantially over the course of the day. However, it is unclear whether there is an association between the sedative success rate of chloral hydrate and the time of day. We conducted a retrospective study of 41,831 cases, to determine if there was a difference in sedation success rate with chloral hydrate in children seen in the morning and afternoon.
Patients who accepted the sedation service were included. Eligible patients were divided into two cohorts of morning and afternoon cases, according to the time of day when the initial dose of chloral hydrate was administered. To ensure that the two groups were comparable, a propensity score matching method was utilized.
The success rate with the initial dose of chloral hydrate was higher in patients who received sedation services in the afternoon. In the subgroup analysis, the afternoon cases had a higher sedation success rate compared to the morning cases in male patients; whereas, in female patients, no difference was detected between the morning versus afternoon cases.
These results show that the afternoon cases had a higher sedation success rate than the morning cases, despite the afternoon cases receiving relatively lower initial dose than the morning cases. However, the clinical significance remains to be discussed, and further prospective studies are needed to validate the findings.
影响药物疗效的生理过程在一天中会发生显著变化。然而，水合氯醛的镇静成功率与一天中的时间之间是否存在关联尚不清楚。我们对41831例病例进行了一项回顾性研究，以确定上午和下午就诊的儿童使用水合氯醛时镇静成功率是否存在差异。
纳入接受镇静服务的患者。根据首次给予水合氯醛的时间，将符合条件的患者分为上午和下午两个队列。为确保两组具有可比性，采用了倾向评分匹配方法。
下午接受镇静服务的患者首次使用水合氯醛的成功率更高。在亚组分析中，男性患者下午病例的镇静成功率高于上午病例；而在女性患者中，上午和下午病例之间未检测到差异。
这些结果表明，尽管下午病例的初始剂量相对低于上午病例，但下午病例的镇静成功率高于上午病例。然而，其临床意义仍有待讨论，需要进一步的前瞻性研究来验证这些发现。
