Related Experiment Video
Updated: Oct 29, 2025
Infant Auditory Processing and Event-related Brain Oscillations
Published on: July 1, 2015
Safety and Complications of Sedation Anesthesia during Pediatric Auditory Brainstem Response Testing
Senem Urfali1, Boran Urfali2, Elif Tugba Sarac3
1Department of Anesthesiology and Reanimation, Tayfur Ata Sökmen Faculty of Medicine, Hatay Mustafa Kemal University, Antakya, Turkey.
Insights
Sedation anesthesia for pediatric auditory brainstem response (ABR) testing is safe, with a low complication rate. Combining sedation drugs may offer benefits over single-drug use, especially for children with comorbidities.
Area of Science:
- Pediatric Anesthesiology
- Neuroscience
- Audiology
Background:
- Auditory Brainstem Response (ABR) testing is crucial for childhood hearing assessment.
- While painless, ABR may require sedation in pediatric patients.
- Evaluating the safety and complications of sedation for ABR is essential.
Purpose of the Study:
- To assess the safety and complication rates of sedation anesthesia during pediatric ABR testing.
- To identify factors influencing sedation safety in this population.
Main Methods:
- Retrospective analysis of 75 pediatric patients undergoing ABR with sedation anesthesia (2018-2020).
- Data collected on patient demographics, comorbidities, drugs used, procedure details, and complications.
- Evaluation of anesthesia applicability, safety, and adverse events.
Main Results:
- A low complication rate (5.33%) was observed, with no severe events like bradycardia or arrest.
- Respiratory distress, agitation, cough, and nausea-vomiting were the reported complications.
- Midazolam was the most common single agent; propofol-ketamine combinations were also used.
Conclusions:
- Sedation anesthesia for pediatric ABR testing demonstrates a low complication rate.
- Combination sedation regimens may be more advantageous than single agents.
- Caution is advised for children with comorbidities due to potential risks of sedative agents.
Objective:
The auditory brainstem response (ABR) test has been widely used in childhood. Although it is a painless procedure, sedation can be needed in pediatric patients. Thus, this study aimed to evaluate safety and complications of sedation anesthesia applied in pediatric patients during ABR testing.
Methods:
Medical records of 75 children who underwent ABR testing between 2018 and 2020 were evaluated retrospectively in terms of applicability, safety, and complications of sedation anesthesia.
Results:
The ages ranged from 3 to 9 (mean 6.2) years. Comorbidity was detected in 20% (n = 15); 3 had multiple comorbidities, and the most common comorbidity was Down syndrome (4%). The drugs used in sedation anesthesia were midazolam in 81.3% (n = 61), a combination of propofol and ketamine in 14.7% (n = 11), and only propofol in 4% (n = 3) of the patients. An additional drug use was needed in 44% (n = 33). The mean procedure time was 40 (range 30-55) min. The mean anesthesia duration was 45 (range 35-60) min. The mean recovery time was 10 (range 5-15) min. Complications related to anesthesia developed in 4 (5.33%) of the patients; respiratory distress, agitation, cough, and nausea-vomiting were seen in one of the patients, respectively. Complications like bradycardia and respiratory or cardiac arrest were not seen at all.
Conclusions:
The complication rate of sedation anesthesia performed during ABR testing of pediatric patients is quite low. It may be more beneficial to use combinations of sedation drugs instead of using a single sedation drug. Although sedation anesthesia appears to be safe in general, the potentially life-threatening complications of sedative agents should be remembered, especially in children who have comorbidities.
