Behrman David B, Bishop Jessica L, Godsell Jeremy, Shirley Brian, Storey Sarah, Carroll William W, Prosser John D
Medical College of Georgia at Augusta University, Department of Otolaryngology, Georgia.
Medical College of Georgia at Augusta University, Department of Otolaryngology, Georgia.
Int J Pediatr Otorhinolaryngol. 2020 Apr;131:109861. doi: 10.1016/j.ijporl.2020.109861. Epub 2020 Jan 3.
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.
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.
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.
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 0.25 mg for patients <3 months of age to 20 mg 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.
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.
查阅关于褪黑素预处理以成功完成儿科患者听觉脑干反应（ABR）测试的文献，并评估褪黑素给药方案。
考克兰图书馆、PubMed、Ovid MEDLINE以及从创刊至2019年5月20日的科学网。此外，我们机构对2015年至2018年间接受褪黑素辅助ABR测试的儿科患者（<18岁）进行了回顾性病例系列研究。
对涉及在儿科患者（<18岁）中使用褪黑素进行听觉脑干反应测试的前瞻性和回顾性研究进行评估。符合纳入/排除标准的研究报告了使用褪黑素预处理的ABR测试成功率、所用褪黑素剂量、睡眠持续时间以及是否发生不良事件。
共识别出43项研究，筛选出8项研究，最终5项研究纳入综述。共有480名儿科患者接受了褪黑素预处理的ABR测试，成功率在65%至86.7%之间。各研究中的年龄范围为1个月至14岁6个月。褪黑素剂量从<3个月龄患者的0.25毫克到>6岁患者的20毫克不等，有一项研究采用基于体重的方法。纳入的任何研究均未报告显著不良事件。
褪黑素预处理可能是在儿科患者中获得非镇静ABR测试成功结果的有用选择，并且可能为镇静提供有用的替代方法。给药模式高度可变。任何给药策略均未报告不良事件。
