Assessing temperament as a predictor of oral sedation success using the Children's Behavior Questionnaire Short Form

Abstract

<bold>Purpose<bold>: To investigate whether temperament as measured by the Children's Behavior Questionnaire Short Form (CBQ-SF) is associated with success in oral sedation. <bold>Methods<bold>: Child-caregiver dyads were enrolled from patients presenting for midazolam, meperidine, and hydroxyzine, oral sedation. Children between 43 and 96 months of age, ASA I or II, able to take radiographs, whose parents believed he/she would swallow oral medications were enrolled. To assess child temperament, caregivers completed the CBQ-SF. Behavior during sedation was measured at timed intervals and overall sedation results were recorded using the Houpt Behavior Rating Scale. Failure was defined by Houpt overall ratings of fair or worse. The presence of disruptive behavior was also quantified. <bold>Results<bold>: The sample population consisted of 61 patient-caregiver dyads with 62% female patients (N=38), an average age of 70 months (SD=13.9), and 51% (N=31) of patients insured by Medicaid. The majority of treatment times were over 60 minutes (53%, N=32). The overall sedation failure rate was 13% (N=8). Presence of disruptive behavior was 28% (N=17). There was not a significant difference in failure rate or presence of disruptive behavior with respect to age, sex, ASA status, insurance status, reason for sedation, or type of treatment provided. A two sample t-test revealed that children with higher values for impulsivity were significantly more likely to have disruptive behavior (p=.043). <bold>Conclusions<bold>: The results of this study suggest that impulsivity may be an important determinant of a child's behavior during sedation, and patient temperament should be considered in case selection for oral sedation.