Review Article

The Effects of Sedation on Auditory Brainstem Response in Pediatric Population: A Systematic Review

Abstract

Background and Aim: Auditory Brainstem Response (ABR) is crucial for evaluating auditory pathway function in pediatric patients. However, obtaining reliable ABR measurements in young children can be challenging due to their inability to stay still and quiet during the test. Sedation is frequently used to facilitate ABR testing in this population, but the most practically effective sedation method and its impact are still uncertain. This systematic review aimed to thoroughly investigate the success rates (completion of ABR in both ears) associated with different sedation techniques.
Recent Findings: In recent review (2000-2022), Ten studies, identified through a comprehensive search of electronic databases, were included in the analysis. The studies reported significant variation in success rates for ABR testing with sedation, ranging from 70% to 100%. This suggests that the effectiveness of sedation may not be uniform across all situations. The included studies employed a wide variety of sedation techniques, highlighting the lack of a standardized approach in this area.
Conclusion: These findings highlight the heterogeneity in sedation practices and success rates for pediatric ABR testing. This emphasizes the importance of tailoring the sedation approach to the specific needs of each child while carefully considering the potential risks associated with each sedation method. Further research is warranted to establish standardized protocols for sedation in pediatric ABR , ensuring optimal test efficacy while prioritizing patient safety. Research Square registration DOI: (https://doi.org/10.21203/rs.3.rs-388140/v1).

1. Jacobson JT, Morehouse CR, Johnson MJ. Strategies for infant auditory brain stem response assessment. Ear Hear. 1982;3(5):263-70. [DOI:10.1097/00003446-198209000-00006]
2. Helfand S, Yifat R. ABR audiometry: application to the paediatric population. S Afr J Commun Disord. 1985;32(1):65-9. [DOI:10.4102/sajcd.v32i1.336]
3. Saad AYSA, Almaflehi N. Effects of auditory brainstem response (ABR) on measuring children’s auditory functions: an experimental investigation. Journal for the Study of English Linguistics. 2013;1(2):15-54.
4. Malviya S, Voepel-Lewis T, Tait AR, Merkel S. Sedation/Analgesia for diagnostic and therapeutic procedures in children. J Perianesth Nurs. 2000;15(6):415-22. [DOI:10.1053/jpan.2000.19472]
5. Valenzuela DG, Kumar DS, Atkins CL, Beers A, Kozak FK, Chadha NK. Chloral hydrate sedation for auditory brainstem response (ABR) testing in children: Safety and effectiveness. Int J Pediatr Otorhinolaryngol. 2016;83:175-8. [DOI:10.1016/j.ijporl.2016.02.006]
6. Behrman DB, Bishop JL, Godsell J, Shirley B, Storey S, Carroll WW, et al. Efficacy of melatonin for auditory brainstem response testing in children: A systematic review. Int J Pediatr Otorhinolaryngol. 2020;131:109861. [DOI:10.1016/j.ijporl.2020.109861]
7. Marra P, Di Stadio A, Colacurcio V, Scarpa A, La Mantia I, Salzano FA, et al. Sedation with Intranasal Dexmedetomidine in the Pediatric Population for Auditory Brainstem Response Testing: Review of the Existing Literature. Healthcare (Basel). 2022;10(2):287. [DOI:10.3390/healthcare10020287]
8. Liu H, Zhang X, Yao X, Jin Y, Liu M, Meng Z, et al. Efficacy and safety of chloral hydrate in auditory brainstem response test: A systematic review and single-arm meta-analysis. Clin Otolaryngol. 2024;49(2):161-75. [DOI:10.1111/coa.14117]
9. Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:l4898. [DOI:10.1136/bmj.l4898]
10. Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in metaanalyses. Eur J Epidemiol. 2010;25(9):603-5. [DOI:10.1007/s10654-010-9491-z]
11. Hajjij A, Tahiri I, Anajar S, Essaadi M, Snoussi K. Melatonin is useful alternative for sedation in children undergoing auditory brainstem responses testing. Eur J Pediatr. 2020;179(9):1431-4. [DOI:10.1007/s00431-020-03632-5]
12. Levit Y, Mandel D, Matot I. Frequency-specific auditory brainstem response testing with age-appropriate sedation. Int J Pediatr Otorhinolaryngol. 2018;108:73-9. [DOI:10.1016/j.ijporl.2018.02.028]
13. Abulebda K, Patel VJ, Ahmed SS, Tori AJ, Lutfi R, Abu-Sultaneh S. Comparison between chloral hydrate and propofolketamine as sedation regimens for pediatric auditory brainstem response testing. Braz J Otorhinolaryngol. 2019;85(1):32-6. [DOI:10.1016/j.bjorl.2017.10.003]
14. Reynolds J, Rogers A, Capehart S, Manyang P, Watcha MF. Retrospective Comparison of Intranasal Dexmedetomidine and Oral Chloral Hydrate for Sedated Auditory Brainstem Response Exams. Hosp Pediatr. 2016;6(3):166-71. [DOI:10.1542/hpeds.2015-0152]
15. Keidan I, Gozal D, Minuskin T, Weinberg M, Barkaly H, Augarten A. The effect of fasting practice on sedation with chloral hydrate. Pediatr Emerg Care. 2004;20(12):805-7. [DOI:10.1097/01.pec.0000148027.53598.b8]
16. Li BL, Yuen VM, Zhou JL, Zhang N, Huang JX, Tian H, et al. A randomized controlled trial of oral chloral hydrate vs intranasal dexmedetomidine plus buccal midazolam for auditory brainstem response testing in children. Paediatr Anaesth. 2018;28(11):1022-8. [DOI:10.1111/pan.13498]
17. Della Volpe A, Dipietro L, Ricci G, Pastore V, Paccone M, Pirozzi C. Pre-treatment with Melamil Tripto® induces sleep in children undergoing Auditory Brain Response (ABR) testing. Int J Pediatr Otorhinolaryngol. 2018;115:171-4. [DOI:10.1016/j.ijporl.2018.10.006]
18. Reynolds J, Rogers A, Medellin E, Guzman JA, Watcha MF. A prospective, randomized, double-blind trial of intranasal dexmedetomidine and oral chloral hydrate for sedated auditory brainstem response (ABR) testing. Paediatr Anaesth. 2016;26(3):286-93. [DOI:10.1111/pan.12854]
19. Akin A, Esmaoglu A, Tosun Z, Gulcu N, Aydogan H, Boyaci A. Comparison of propofol with propofol-ketamine combination in pediatric patients undergoing auditory brainstem response testing. Int J Pediatr Otorhinolaryngol. 2005;69(11):1541-5. [DOI:10.1016/j.ijporl.2005.04.011]
Files
IssueVol 33 No 4 (2024) QRcode
SectionReview Article(s)
DOI https://doi.org/10.18502/avr.v33i4.16646
Keywords
Auditory brainstem response sedation chloral hydrate children; dexmedetomidine intranasal drug administration
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Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Fallahnezhad T, Sharafi MA, Mazaheryazdi M, Jarollahi F, Pourbakht A. The Effects of Sedation on Auditory Brainstem Response in Pediatric Population: A Systematic Review. Aud Vestib Res. 2024;33(4):282-293.