Further epidemiological investigations could assist in identifying areas of opportunity for quality improvement initiatives related specifically to the practice of administering as-needed (or rescue) sedative and analgesic medications in the ICU setting. The frequency of rescue sedative and analgesic medications can be a useful and easily quantifiable demographic marker for steady-state pain control and comfort management. The use of as-needed medications reflects the bedside provider’s interpretation of the patient’s discomfort or anxiety. The goal tis study was to discribe the epidemiology of as-needed sedative and analgesic medications in the pediatric CVICU and specifically the influence of time of day in our clinical practice.