Della Volpe A, Dipietro L, Ricci G, Pastore V, Paccone M, Pirozzi C, Di Stadio A
Santobono-Pausillipon Hospital, Otolaryngology Department, Cochlear Implant Unit, Naples, Italy.
Highland Instruments, Cambridge, MA, USA.
Int J Pediatr Otorhinolaryngol. 2018 Dec;115:171-174. doi: 10.1016/j.ijporl.2018.10.006. Epub 2018 Oct 4.
Previous studies have shown that tryptophan and vitamin B6 used in conjunction with melatonin induce sleep more effectively than melatonin alone. This study aims at evaluating the efficacy of different dosages and timings of administration of a solution containing melatonin, tryptophan, and vitamin B6 for inducing sleep in children undergoing ABR testing.
294 children scheduled for Auditory Brain Response (ABR) evaluation were administered a solution containing melatonin, tryptophan, and vitamin B6 to induce sleep before the exam. Two different administration timings (pre-treatment and single shot treatment) and three dosages (0.5 ml in pre-treatment, 1.5 ml in pre-treatment, and 3 ml in single shot) were tested. The following parameters were evaluated: time needed for the subject to fall asleep before ABR testing, subject sl'eep features during ABR testing (quality, stability, duration), recorded ABR quality (including presence of abnormalities in amplitude and latency), subject waking up modality, and time needed for the subject to wake up at the end of the ABR exam.
Quality of ABR signals was similar across treatments, and subjects responded in a similar manner in terms of time needed to wake-up and wake-up modality. However, pretreatment with the 1.5 ml dose induced sleep faster than the two other dosages, and the length of the induced sleep was longer than that induced by pre-treatment with 0.5 ml. In general, the pre-treatment with 1.5 ml led to a shorter ABR exam, because reduces the time for inducing sleep, allows a long sleeping phase with a good quality, without variation in the wakening up times.
Melamil Tripto is an alternative to sedative drugs for inducing sleep in pediatric subjects undergoing ABR testing. A pre-medication with 1.5 ml of MT 1 week before ABR testing further improves the strength of the solution.
先前的研究表明，色氨酸和维生素B6与褪黑素联合使用比单独使用褪黑素更有效地诱导睡眠。本研究旨在评估含有褪黑素、色氨酸和维生素B6的溶液在不同剂量和给药时间对接受听性脑干反应（ABR）测试的儿童诱导睡眠的效果。
294名计划进行听性脑干反应（ABR）评估的儿童在检查前服用含有褪黑素、色氨酸和维生素B6的溶液以诱导睡眠。测试了两种不同的给药时间（预处理和单次给药）和三种剂量（预处理0.5毫升、预处理1.5毫升和单次给药3毫升）。评估了以下参数：ABR测试前受试者入睡所需时间、ABR测试期间受试者的睡眠特征（质量、稳定性、持续时间）、记录的ABR质量（包括幅度和潜伏期的异常情况）、受试者醒来方式以及ABR检查结束时受试者醒来所需时间。
不同治疗组的ABR信号质量相似，受试者在醒来所需时间和醒来方式方面的反应相似。然而，1.5毫升剂量的预处理比其他两种剂量诱导睡眠更快，诱导睡眠的时长比0.5毫升预处理诱导的更长。一般来说，1.5毫升的预处理导致ABR检查时间更短，因为它减少了诱导睡眠的时间，允许有一个高质量的长睡眠阶段，且醒来时间没有变化。
Melamil Tripto是用于接受ABR测试的儿科受试者诱导睡眠的镇静药物的替代品。在ABR测试前1周用1.5毫升MT进行预处理可进一步提高溶液的效力。
