Sedation for children 2 to 5 years of age undergoing auditory brainstem response and auditory steady state responses...

Area of Science:

• Pediatric audiology
• Neurophysiology
• Pharmacology

Background:

• Auditory brain stem responses (ABR) and auditory steady-state responses (ASSR) are crucial for assessing hearing in young children.
• Behavioral testing is often not feasible in children aged 2-5 years due to developmental delays or behavioral issues.
• General anesthesia is a common but resource-intensive method for audiological testing in uncooperative children.

Purpose of the Study:

• To assess the feasibility, duration, and outcomes of sedation using intrarectal pentobarbital and oral alimemazine.
• To evaluate the effectiveness of this sedation protocol for ABR and ASSR recordings in children aged 2-5 years.
• To determine if this sedation method is a viable alternative to general anesthesia.

Main Methods:

• A prospective study involving 180 children aged 2-5 years who required ABR and ASSR testing.
• Children who did not nap spontaneously received sedation with intrarectal pentobarbital, optionally potentiated by oral alimemazine.
• Data collected included sedation success rates, time to sleep, and recording duration.

Main Results:

• Only 23 children (12.8%) achieved a spontaneous nap.
• Sedation was administered to 157 children (72 with pentobarbital alone, 85 with both agents).
• Recordings were successfully completed in 89.8% of sedated children, with average recording times of 20 minutes for ABR and 25 minutes for ASSR.

Conclusions:

• Intrarectal pentobarbital, with or without oral alimemazine, is a feasible and effective sedation method for pediatric ABR and ASSR.
• This sedation approach allows for successful audiological testing in a high percentage of children who do not nap.
• It presents a valuable alternative to general anesthesia, potentially reducing costs and risks.