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Sedation Methods in Paediatric Auditory Electrophysiologic Testing: A Narrative Review
Violeta Necula1,2, Maria Eugenia Domuta3, Raluca Olariu4,5
1Otorhinolaryngology Department, "Iuliu Hatieganu" University of Medicine and Pharmacy Cluj-Napoca, 400012 Cluj-Napoca, Romania.
Insights
Objective hearing tests like auditory brainstem response (ABR) and auditory steady-state response (ASSR) require sedation in infants over six months. This review evaluates sedation methods for safe and effective ABR/ASSR testing in children.
Area of Science:
- Pediatric audiology
- Clinical neurophysiology
- Anesthesiology
Background:
- Neonatal hearing screening has improved early detection of hearing loss.
- Objective electrophysiological tests like auditory brainstem response (ABR) and auditory steady-state response (ASSR) are crucial for diagnosing hearing impairments in infants over six months.
- Accurate ABR/ASSR results depend on the child being asleep to minimize motion and muscle artifact.
Purpose of the Study:
- To review and evaluate sedation strategies for pediatric procedures.
- To focus on the efficacy, safety, and practicality of sedation agents and routes for inducing sleep during ABR/ASSR testing.
- To guide the selection of appropriate sedation for reliable audiological assessments.
Main Methods:
- Narrative review of existing literature on sedation in pediatric audiology.
- Evaluation of different sedation agents and administration routes.
- Analysis of safety profiles, efficacy rates, and practical considerations for sedation in ABR/ASSR testing.
Main Results:
- Sedation is frequently required for reliable ABR/ASSR testing in infants and young children.
- Various sedation agents and routes can be employed, each with specific benefits and risks.
- The choice of sedation must be individualized based on the child's age, health, and procedural requirements.
Conclusions:
- Sedation is a critical component for obtaining accurate electrophysiological hearing assessments in pediatric patients.
- Optimizing sedation strategies enhances patient safety and the reliability of diagnostic results.
- Individualized sedation plans are essential for successful ABR/ASSR testing in children.
Abstract:
Implementing neonatal hearing screening has significantly reduced the age at which hearing impairments are detected in children. Nevertheless, objective electrophysiological assessments, such as auditory brainstem response (ABR) or auditory steady-state response (ASSR) testing, are often necessary for children older than six months. These evaluations should be conducted while the child is asleep to obtain accurate and interpretable results, as movement and muscle activity can introduce artifacts that compromise the quality of the recordings. In this narrative review, we evaluate sedation strategies in paediatric procedures, focusing on the efficacy, safety, and practicality of agents/routes for inducing sleep during ABR/ASSR testing. Sedation choices should prioritise patient safety, clinical context, and result reliability and be tailored to the individual's age, health status, and procedural needs.
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