Efficiency of Melatonin as a Sedative for Auditory Brainstem Response in Children
Anass Chaouki1, Zineb El Krimi1, Amine Mkhatri1
1Faculty of Medicine of Casablanca, Casablanca 20 000, Morocco.
Insights
Melatonin effectively induces sleep for auditory brainstem response (ABR) testing in children, offering a safer alternative to anesthesia. This method proved successful in over 70% of cases, demonstrating its viability in pediatric audiology.
Area of Science:
- Pediatric Audiology
- Sleep Medicine
- Neuroscience
Background:
- Auditory brainstem response (ABR) testing is crucial in pediatric audiology but often necessitates sedation or general anesthesia.
- Melatonin has emerged as a safe sleep-inducing agent for pediatric procedures like MRI and EEG.
Purpose of the Study:
- To evaluate the efficacy of oral melatonin as a substitute for sedation or general anesthesia during ABR testing in children.
Main Methods:
- 33 children with suspected hearing loss received oral melatonin (5 mg initial dose, with re-administration if needed) for sleep induction.
- Click-induced ABR tests were conducted on both ears under melatonin-induced sleep.
- Data on sleep induction, test completion, and patient demographics were collected.
Main Results:
- ABR testing was successfully completed in 72.7% of children using melatonin-induced sleep.
- The average time for sleep induction and ABR testing was 45 minutes.
- Successful completion was significantly associated with receiving a maintenance melatonin dose (p < 0.001) and the degree of hearing loss (p < 0.001).
Conclusions:
- Melatonin-induced sleep presents a safe and effective alternative to anesthesia for pediatric ABR testing.
- The administration is simple, well-tolerated by children, and parent-approved.
- This approach enhances the safety profile of audiological assessments in young children.
Abstract:
Introduction-Although auditory brainstem response (ABR) testing is among the most frequently used investigations in pediatric audiology and it often requires sedation or general anesthesia. In recent years, melatonin has been successfully used as an alternative way of inducing sleep, particularly in children undergoing magnetic resonance imaging (MRI) or electroencephalography (EEG). Purpose-To assess the effectiveness of orally administered melatonin as an alternative to sedation or general anesthesia during ABR testing. Method-In total, 33 children with suspected hearing loss underwent ABR tests in melatonin-induced sleep. Each patient received an initial dose of 5 mg, which was re-administered in case of failure to obtain sleep. Click-induced ABR tests were performed on both ears. Results-ABR tests were successfully performed in 72.7% of the patients. The average total length of time needed to obtain sleep and complete the ABR testing was 45 min. There was no significant difference between the patients who completed the examination and those who did not in terms of age or psychomotor development. There was a statistically significant association between receiving a maintenance dose and successful completion of the test (p < 0.001). There was also a significant connection between the degree of hearing loss and the success rate of the ABR tests (p < 0.001). Conclusions-Melatonin-induced sleep is a good and safer alternative to anesthesia to perform ABR testing in young children. It is easily administered, tolerated by the patients, and accepted by parents.
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