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Intranasal dexmedetomidine for sedation in ABR testing in children: No pain, big gain!
Ana Giordano1, Brigitte Lehner1, Anca Voicu1
1Department of Pediatric Otorhinolaryngology-Head & Neck Surgery, Hôpitaux Pédiatriques de Nice CHU- Lenval, Nice, France; Fondation Lenval, Nice, France.
Insights
Intranasal dexmedetomidine effectively sedates children for auditory brainstem response (ABR) testing. This noninvasive method shows a high success rate with manageable side effects, aiding non-cooperative children.
Area of Science:
- Pediatric Anesthesiology
- Neuroscience
- Pharmacology
Background:
- Auditory Brainstem Response (ABR) testing in children often requires sedation for accurate results.
- Achieving immobility or sleep in pediatric patients for ABR can be challenging.
Purpose of the Study:
- To evaluate the effectiveness and safety of intranasal dexmedetomidine for sedating children undergoing ABR testing.
- To determine the success rate, onset and recovery times, and side effects of this sedation method.
Main Methods:
- A prospective study included 59 children aged 1-15 years requiring sedation for ABR testing.
- Intranasal dexmedetomidine was administered at 2.5 μg/kg, with an optional 1 μg/kg repeat dose.
- Data collected included sedation success, onset/recovery times, and adverse events.
Main Results:
- Successful ABR testing was achieved in 57 out of 59 patients (96.6% success rate).
- Median onset of sleep was 32 minutes, and median recovery time was 48 minutes.
- Bradycardia (31 patients) and hypotension (28 patients) were observed but resolved without intervention.
Conclusions:
- Intranasal dexmedetomidine is an effective, safe, and noninvasive sedation option for pediatric ABR testing.
- This method is particularly beneficial for non-cooperative children.
- It offers a simple and reliable approach to pediatric procedural sedation.
Objectives:
Obtaining perfect immobility or sleep in children undergoing ABR auditory brainstem response) testing can be challenging. We examined the effectiveness and safety of intranasal dexmedetomidine for sedation of children undergoing ABR testing.
Material And Methods:
We included prospectively all patients aged from 1 to 15 years for whom sedation for ABR testing was required, between July 2018 and November 2021. We administered an initial dose of 2.5 μg/kg intranasal dexmedetomidine with a repeat dose of 1 μg/kg if needed 30 min later. Collected data included success rate of sedation, sedation onset and recovery times and incidence of side effects.
Results:
ABR testing was undertaken successfully in 57 of the 59 patients, giving a total success rate of 96,6 %. (95 % confidence interval 88.5 %-99.1 %). The median time to onset of sleep was 32 ± 18.3 min. The median duration of sedation recovery time was 48 ± 24.7 min. We recorded the adverse effects. Thirty-one patients experienced bradycardia and 28 patients experienced hypotension, all of which resolved without intervention.
Conclusion:
Intranasal dexmedetomidine is an effective, safe, simple of use and noninvasive method for sedation in children. It could have a major role in auditory brainstem response testing, specially in the case of non-cooperative children.
Registration Number Of The Trial:
NCT03530371.
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