Intranasal dexmedetomidine for sedation in ABR testing in children: No pain, big gain!

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 mu g/kg intranasal dexmedetomidine with a repeat dose of 1 mu g/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 d urat i on o f se d at i on 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 noncooperative children. Registration number of the trial: NCT03530371.