Efficacy of Melatonin for Auditory Brainstem Response Testing in Children: A Systematic Review:
Publication date: Available online 3 January 2020
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): David B. Behrman, Jessica L. Bishop, Jeremy Godsell, Brian Shirley, Sarah Storey, William W. Carroll, John D. Prosser
Abstract
Objective
To examine the literature on pre-treatment with melatonin for successful completion of Auditory Brainstem Response (ABR) testing in pediatric patients and evaluate melatonin dosing protocols.Data Sources
The Cochrane Library, PubMed, Ovid MEDLINE, and Web of Science from inception through May 20th, 2019. In addition, a retrospective case series of pediatric patients (<18yr) who underwent melatonin assisted ABR testing between 2015 and 2018 was performed at our institution.Review Methods
Prospective and retrospective studies involving melatonin use in pediatric patients (<18yrs) for auditory brainstem response testing were evaluated. Studies meeting inclusion/exclusion criteria reported success rate of ABR testing using melatonin pre-treatment, dosage of melatonin used, duration of sleep, and whether adverse events occurred.Results
43 studies were identified, 8 studies were selected, and finally 5 studies were included in the review. A total of 480 pediatric patients underwent ABR testing with pre-treatment of melatonin with success rates ranging from 65% to 86.7%. Age across studies ranged from 1 month to 14 years, 6 months. Dosage of melatonin varied from 0.25mg for patients <3 months of age to 20mg for patients >6 years of age, with one study using a weight-based approach. No significant adverse events were reported by any of the included studies.Conclusion
Pre-medication with melatonin may be a useful option for obtaining successful results of non-sedated ABR testing in pediatric patients and may provide a useful alternative to sedation. Dosing patterns are highly variable. No adverse events were reported with any dosing strategy.
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