[The use of melatonin as an alternative to sedation in children undergoing brainstem audiometry].
BACKGROUND
Though one of the most important investigations in paediatric audiology, brainstem evoked response audiometry (BERA) often necessitates sedation or general anaesthetics, especially in newborn and infants. In paediatric neurology, melatonin has been successfully used for some years to induce sleep prior to EEG investigations. Melatonin as a hormone regulating the circadian rhythm induces natural sleep without the risks of sedation. Side effects are not known.


METHODS
Click-induced BERA was first performed in 10 adults with normal hearing with and without previous melatonin administration, and click thresholds and latencies of evoked potentials were compared. 50 children then underwent BERA in melatonin-induced sleep.


RESULTS
Click thresholds in adults were mostly identical (r = 0,88), while the mean latencies of evoked potentials seemed to be minimally prolonged (r from 0,82 to 0,95). Click-induced BERA was successful in 45 of the 50 children, and notched-noise BERA in at least 2 frequencies in 38 of 43 children.


CONCLUSIONS
Offering a high success rate with no side effects, melatonin-induced sleep seems to be a good alternative to sedation. This method is widely accepted by parents and permits earlier diagnosis of hearing impairment in the routine clinical setting.
Universitätsklinikum Münster, Klinik und Poliklinik für Phoniatrie und Pädaudiologie, Kardinal-von-Galen-Ring 10, 48149 Münster. michael.schmidt@uni-muenster
C-M
CM
Schmidt
J E
JE
Bohlender
D
D
Deuster
A
A
Knief
P
P
Matulat
A G
AG
Dinnesen
D000293:Adolescent; D000328:Adult; D001300:Audiometry, Evoked Response / Q000379:methods*; D001364:Awareness / Q000187:drug effects / Q000502:physiology; D001933:Brain Stem / Q000187:drug effects / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D016057:Evoked Potentials, Auditory, Brain Stem / Q000187:drug effects / Q000502:physiology; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D008297:Male; D008550:Melatonin / Q000008:administration & dosage; D011292:Premedication; D011930:Reaction Time / Q000187:drug effects / Q000502:physiology; D012890:Sleep / Q000187:drug effects / Q000502:physiology
D006993:Hypnotics and Sedatives; D008550:Melatonin