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Comparison between chloral hydrate and propofol-ketamine as sedation regimens for pediatric auditory brainstem response testing.
Braz J Otorhinolaryngol 2019 Jan - Feb; 85(1):32-36BJ

Abstract

INTRODUCTION

The use of diagnostic auditory brainstem response testing under sedation is currently the "gold standard" in infants and young children who are not developmentally capable of completing the test.

OBJECTIVE

The aim of the study is to compare a propofol-ketamine regimen to an oral chloral hydrate regimen for sedating children undergoing auditory brainstem response testing.

METHODS

Patients between 4 months and 6 years who required sedation for auditory brainstem response testing were included in this retrospective study. Drugs doses, adverse effects, sedation times, and the effectiveness of the sedative regimens were reviewed.

RESULTS

73 patients underwent oral chloral hydrate sedation, while 117 received propofol-ketamine sedation. 12% of the patients in the chloral hydrate group failed to achieve desired sedation level. The average procedure, recovery and total nursing times were significantly lower in the propofol-ketamine group. Propofol-ketamine group experienced higher incidence of transient hypoxemia.

CONCLUSION

Both sedation regimens can be successfully used for sedating children undergoing auditory brainstem response testing. While deep sedation using propofol-ketamine regimen offers more efficiency than moderate sedation using chloral hydrate, it does carry a higher incidence of transient hypoxemia, which warrants the use of a highly skilled team trained in pediatric cardio-respiratory monitoring and airway management.

Authors+Show Affiliations

Indiana University Health, Indiana University School of Medicine and Riley Hospital for Children, Department of Pediatrics, Section of Pediatric Critical Care Medicine, Indianapolis, United States. Electronic address: kabulebd@iupui.edu.Indiana University Health, Indiana University School of Medicine and Riley Hospital for Children, Department of Pediatrics, Section of Pediatric Critical Care Medicine, Indianapolis, United States.Indiana University Health, Indiana University School of Medicine and Riley Hospital for Children, Department of Pediatrics, Section of Pediatric Critical Care Medicine, Indianapolis, United States.Indiana University Health, Indiana University School of Medicine and Riley Hospital for Children, Department of Pediatrics, Section of Pediatric Critical Care Medicine, Indianapolis, United States.Indiana University Health, Indiana University School of Medicine and Riley Hospital for Children, Department of Pediatrics, Section of Pediatric Critical Care Medicine, Indianapolis, United States.Indiana University Health, Indiana University School of Medicine and Riley Hospital for Children, Department of Pediatrics, Section of Pediatric Critical Care Medicine, Indianapolis, United States.

Pub Type(s)

Comparative Study
Evaluation Studies
Journal Article

Language

eng

PubMed ID

29137881

Citation

Abulebda, Kamal, et al. "Comparison Between Chloral Hydrate and Propofol-ketamine as Sedation Regimens for Pediatric Auditory Brainstem Response Testing." Brazilian Journal of Otorhinolaryngology, vol. 85, no. 1, 2019, pp. 32-36.
Abulebda K, Patel VJ, Ahmed SS, et al. Comparison between chloral hydrate and propofol-ketamine as sedation regimens for pediatric auditory brainstem response testing. Braz J Otorhinolaryngol. 2019;85(1):32-36.
Abulebda, K., Patel, V. J., Ahmed, S. S., Tori, A. J., Lutfi, R., & Abu-Sultaneh, S. (2019). Comparison between chloral hydrate and propofol-ketamine as sedation regimens for pediatric auditory brainstem response testing. Brazilian Journal of Otorhinolaryngology, 85(1), pp. 32-36. doi:10.1016/j.bjorl.2017.10.003.
Abulebda K, et al. Comparison Between Chloral Hydrate and Propofol-ketamine as Sedation Regimens for Pediatric Auditory Brainstem Response Testing. Braz J Otorhinolaryngol. 2019;85(1):32-36. PubMed PMID: 29137881.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison between chloral hydrate and propofol-ketamine as sedation regimens for pediatric auditory brainstem response testing. AU - Abulebda,Kamal, AU - Patel,Vinit J, AU - Ahmed,Sheikh S, AU - Tori,Alvaro J, AU - Lutfi,Riad, AU - Abu-Sultaneh,Samer, Y1 - 2017/10/28/ PY - 2017/08/21/received PY - 2017/10/03/accepted PY - 2017/11/16/pubmed PY - 2019/2/8/medline PY - 2017/11/16/entrez KW - Auditory brainstem response testing KW - Chloral hydrate KW - Hidrato de cloral KW - Potencial evocado auditivo de tronco encefálico KW - Procedural sedation KW - Propofol KW - Sedação para procedimentos SP - 32 EP - 36 JF - Brazilian journal of otorhinolaryngology JO - Braz J Otorhinolaryngol VL - 85 IS - 1 N2 - INTRODUCTION: The use of diagnostic auditory brainstem response testing under sedation is currently the "gold standard" in infants and young children who are not developmentally capable of completing the test. OBJECTIVE: The aim of the study is to compare a propofol-ketamine regimen to an oral chloral hydrate regimen for sedating children undergoing auditory brainstem response testing. METHODS: Patients between 4 months and 6 years who required sedation for auditory brainstem response testing were included in this retrospective study. Drugs doses, adverse effects, sedation times, and the effectiveness of the sedative regimens were reviewed. RESULTS: 73 patients underwent oral chloral hydrate sedation, while 117 received propofol-ketamine sedation. 12% of the patients in the chloral hydrate group failed to achieve desired sedation level. The average procedure, recovery and total nursing times were significantly lower in the propofol-ketamine group. Propofol-ketamine group experienced higher incidence of transient hypoxemia. CONCLUSION: Both sedation regimens can be successfully used for sedating children undergoing auditory brainstem response testing. While deep sedation using propofol-ketamine regimen offers more efficiency than moderate sedation using chloral hydrate, it does carry a higher incidence of transient hypoxemia, which warrants the use of a highly skilled team trained in pediatric cardio-respiratory monitoring and airway management. SN - 1808-8686 UR - https://www.unboundmedicine.com/medline/citation/29137881/Comparison_between_chloral_hydrate_and_propofol_ketamine_as_sedation_regimens_for_pediatric_auditory_brainstem_response_testing_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1808-8694(17)30184-2 DB - PRIME DP - Unbound Medicine ER -