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Comparison between chloral hydrate and propofol-ketamine as sedation regimens for pediatric auditory brainstem

Kamal Abulebda1, Vinit J Patel1, Sheikh S Ahmed1

  • 1Indiana University Health, Indiana University School of Medicine and Riley Hospital for Children, Department of Pediatrics, Section of Pediatric Critical Care Medicine, Indianapolis, United States.

Brazilian Journal of Otorhinolaryngology
|November 16, 2017
PubMed

Insights

Propofol-ketamine sedation is more efficient for auditory brainstem response testing in children than chloral hydrate. However, propofol-ketamine increases the risk of transient hypoxemia, requiring careful monitoring.

Area of Science:

  • Pediatric Anesthesiology
  • Neurophysiology
  • Diagnostic Testing

Background:

  • Auditory brainstem response (ABR) testing under sedation is the standard for infants and young children.
  • Assessing hearing in non-cooperative pediatric populations is critical.

Purpose of the Study:

  • To compare the efficacy and safety of propofol-ketamine versus oral chloral hydrate for sedating children during ABR testing.
  • Evaluating sedative effectiveness, adverse events, and procedural efficiency.

Main Methods:

  • Retrospective review of 190 pediatric patients (4 months to 6 years) undergoing ABR testing.
  • Analysis of drug doses, adverse effects, sedation duration, and procedure success rates for two sedative regimens.

Main Results:

  • Propofol-ketamine (n=117) showed higher success rates than chloral hydrate (n=73).
  • Shorter procedure, recovery, and nursing times were observed with propofol-ketamine.
  • The propofol-ketamine group had a higher incidence of transient hypoxemia.

Conclusions:

  • Both propofol-ketamine and chloral hydrate are viable sedation options for pediatric ABR testing.
  • Propofol-ketamine offers greater efficiency but necessitates advanced monitoring and skilled personnel due to increased hypoxemia risk.
  • Careful patient selection and monitoring are essential for safe and effective sedation.
Abstract

Keywords:
Auditory brainstem response testingChloral hydrateHidrato de cloralPotencial evocado auditivo de tronco encefálicoProcedural sedationPropofolSedação para procedimentos

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