Background: Proper sedation in ill children can enhance treatment outcomes, provide comfort, control pain, reduce delirium, and prevent self-extubation. This study aimed to compare the “Comfort Scale” with the “State Behavioral Scale” (SBS) in children under mechanical ventilation in the ICU to develop a sedation protocol. Methods: This study assessed 50 children, ranging from one month to 15 years of age, who were hospitalized in the ICU of Mofid Hospital for over four months. The convenience sampling method was used to select participants, who were then divided into two groups of 25 each (one for the Comfort Scale and one for the SBS). Data were analyzed using SPSS version 20, with a P-value of less than 0.05, which is considered statistically significant. Results: The mean age of the patients was 30.3 months (ranging from 1 to 150 months), with 19 female patients (38%) and 31 male patients (62%). The time taken for scoring by hospital staff was significantly shorter in the SBS group than in the Comfort Scale group (P < 0.0001). There were no significant differences between the two groups in terms of hospitalization duration and the amounts of benzodiazepines and opiates used (P > 0.05). Both tools were associated with a decrease in the length of hospitalization. Conclusions: The findings suggest that the SBS requires less time to administer than the Comfort Scale and can be considered a rapid method. Utilizing both the SBS and Comfort Scale can reduce the length of hospital stays and, consequently, the incidence of ventilator-associated pneumonia.