METHODS OF SEDATION FOR AUDITORY BRAIN-STEM RESPONSE TESTING

Young children and those who are mentally impaired frequently require sedation to attain accurate results when testing for auditory brainste m response (ABR). There have been no previous studies of appropriate m ethods of sedation, and there is no consensus on pharmacotherapy, moni toring equipment, facilities, or personnel necessary for safe and effe ctive ABR testing. To obtain a national census of current practice, we sent a survey to 149 free-standing children's hospitals in the US. A prospective study was also conducted to assess the effects of sedation utilized to perform ABR testing at The Children's Hospital of Alabama . Oral chloral hydrate (50 mg/kg) was administered for sedation in an outpatient setting with a registered nurse and audiologist present, wh ile vital signs, skin color, and oxygen saturation were continuously m onitored. The cost of testing in an audiology or other outpatient suit e was compared with the cost of performing the study in the operating room. Results of the survey illustrated the present lack of national u niformity in sedation administered, as well as various problems and co mplications encountered with such testing. We found that 50 mg/kg chlo ral hydrate administered in this setting is safe and effective for chi ldren requiring sedation for audiologic testing. Further, the ability to perform ABR's in an outpatient suite in a monitored setting is more cost-effective than testing in the operating room.