Hearing loss is the most common sensory disability in the world, hearing loss should be early diagnosed and treated since; it leads to speech and language disorders. Auditory brainstem response (ABR) or Auditory evoked potential (AEP) is a neurologic test done by an audiologist to measure auditory evoke potential. Different types of sedation levels are used during auditory brainstem response test. Therefore, the aim of present study was evaluation of the sedative effect of chloral hydrate during auditory brainstem response (ABR) on children with hearing problems. Randomized selection of 160 children with age ranged between 1-5 years with hearing disorders, they were divided into: Group A: Received 20 mg/Kg chloral hydrate orally. Group B: Received 20 mg/Kg chloral hydrate orally plus 0.5 mg/Kg diazepam rectally. Group C: Received 40 mg/Kg chloral hydrate orally. Group D: Received 40 mg/Kg chloral hydrate orally plus 0.5 mg/Kg diazepam rectally. Regarding ABR testing results, positive ABR test was superior in combined group compared to other groups p=0.005 whereas; negative ABR test was low in combined group compared to other groups p=0.006. At the end of ABR testing 118.52±9.88 of testing children in combined group completed the test compared to other groups p=0.0139 while; 98.21±7.22 of testing children in combined group not completed ABR test compared to other groups p=0.005.In conclusion, combined chloral hydrate plus diazepam give more significant sedative effect than chloral hydrate alone during ABR testing in children with hearing disorders.
Published in | International Journal of Psychological and Brain Sciences (Volume 1, Issue 2) |
DOI | 10.11648/j.ijpbs.20160102.13 |
Page(s) | 32-39 |
Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
Copyright |
Copyright © The Author(s), 2016. Published by Science Publishing Group |
ABR, Chloral Hydrate, Diazepam, Hearing Loss
[1] | Mamo SK, Reed NS, Nieman CL, Oh ES, Lin FR. Personal Sound Amplifiers for Adults with Hearing Loss. Am J Med. 2016; 129 (3): 245-50. |
[2] | Brinkman TM, Bass JK, Li Z, Ness KK, Gajjar A, Pappo AS. Treatment-induced hearing loss and adult social outcomes in survivors of childhood CNS and non-CNS solid tumors: Results from the St. Jude Lifetime Cohort Study. Cancer. 2015 15; 121 (22): 4053-61. |
[3] | Derin S, Cam OH, Beydilli H, Acar E, Elicora SS, Sahan M. Initial assessment of hearing loss using a mobile application for audiological evaluation. J Laryngol Otol. 2016; 130 (3): 248-51. |
[4] | El-Badry MM, Hamdy NA, Sobhy S, Gamal R. Epileptiform electroencephalogram abnormality in children with congenital sensorineural hearing loss. Int J Pediatr Otorhinolaryngol. 2014; 78 (4): 623-30. |
[5] | Jewett DL, Williston JS. Auditory-evoked far fields averaged from the scalp of humans. Brain. 1971; 94 (4): 681-96. |
[6] | Van Yper LN, Vermeire K, De Vel EF, Battmer RD, Dhooge IJ. Binaural interaction in the auditory brainstem response: a normative study. Clin Neurophysiol. 2015; 126 (4): 772-9. |
[7] | Kabacińska A, Stańczyk D, Tarnowska C, Konarska A. Application of conscious sedation in infants undergoing the auditory brainstem responses (ABR) examination. Otolaryngol Pol. 2005; 59 (2): 267-70. |
[8] | Tas A, Yagiz R, Tas M, Esme M, Uzun C, Karasalihoglu AR. Evaluation of hearing in children with autism by using TEOAE and ABR. Autism. 2007; 11 (1): 73-9. |
[9] | Mühler R, Rahne T, Mentzel K, Verhey JL. 40-Hz multiple auditory steady-state responses to narrow-band chirps in sedated and anaesthetized infants. Int J Pediatr Otorhinolaryngol. 2014; 78 (5): 762-8. |
[10] | Baier NM, Mendez SS, Kimm D, Velazquez AE, Schroeder AR. Intranasal dexmedetomidine: an effective sedative agent for electroencephalogram and auditory brain response testing. Paediatr Anaesth. 2016; 26 (3): 280-5. |
[11] | Arevalo JJ, Brinkkemper T, van der Heide A, Rietjens JA, Ribbe M, Deliens L, et al. Palliative sedation: reliability and validity of sedation scales. J Pain Symptom Manage. 2012; 44 (5): 704-14. |
[12] | Gauillard J, Cheref S, Vacherontrystram MN, Martin JC. Chloral hydrate: a hypnotic best forgotten. Encephale. 2002; 28 (3 Pt 1): 200-4. |
[13] | Shroads AL, Coats BS, Langaee T, Shuster JJ, Stacpoole PW. Chloral hydrate, through biotransformation to dichloroacetate, inhibits maleylacetoacetate isomerase and tyrosine catabolism in humans. Drug Metab Pers Ther. 2015; 30 (1): 49-55. |
[14] | Sabia R, Ciogli A, Pierini M, Gasparrini F, Villani C. Dynamic high performance liquid chromatography on chiral stationary phases. Low temperature separation of the interconverting enantiomers of diazepam, flunitrazepam, prazepam and tetrazepam. J Chromatogr A. 2014 Oct 10; 1363: 144-9. |
[15] | Horii Y, Kawaguchi M. Higher detection sensitivity of anxiolytic effects of diazepam by ledge-free open arm with opaque walled closed arm elevated plus maze in male rats. Behav Brain Res. 2015; 294: 131-40. |
[16] | Engelman R, Baker RA, Likosky DS, Grigore A, Dickinson TA, Shore-Lesserson L, et al. The Society of Thoracic Surgeons, The Society of Cardiovascular Anesthesiologists, and The AmericanSociety of ExtraCorporeal Technology: Clinical Practice Guidelines for Cardiopulmonary Bypass--Temperature Management During Cardiopulmonary Bypass. Ann Thorac Surg. 2015; 100 (2): 748-57. |
[17] | Van Dishoeck AM, van der Hooft T, Simoons ML, van der Ent M, Scholte op Reimer WJ. Reliable assessment of sedation level in routine clinical practice by adding an instruction to the Ramsay Scale. Eur J Cardiovasc Nurs. 2009; 8 (2): 125-8. |
[18] | KooSH, LeeDG. Optimal initial dose of chloral hydrate in management of pediatric facial laceration. Arch Plast Surg. 2014; 41 (1): 40-4. |
[19] | Valenzuela DG, Kumar DS, Atkins CL, Beers A, Kozak FK, Chadha NK .Chloral hydrate sedation for auditory brainstem response (ABR) testing in children: Safety and effectiveness. Int J Pediatr Otorhinolaryngol. 2016; 83: 175-8. |
[20] | Nordt SP, Rangan C, Hardmaslani M, Clark RF, Wendler C, Valente M. Pediatric chloral hydrate poisonings and death following outpatient procedural sedation. J Med Toxicol. 2014; 10 (2): 219-22. |
[21] | Keidan I, Gozal D, Minuskin T, Weinberg M, Barkaly H, Augarten A. The effect of fasting practice on sedation with chloral hydrate. Pediatr Emerg Care. 2004; 20 (12): 805-7. |
[22] | Akaike N, Hattori K, Inomata N, Oomura Y. gamma-Aminobutyric-acid- and pentobarbitone-gated chloride currents in internally perfused frog sensory neurones. J Physiol. 1985; 360: 367-86. |
[23] | Sigel E, Baur R, Trube G, Möhler H, Malherbe P. The effect of subunit composition of rat brain GABAA receptors on channel function. Neuron. 1990; 5 (5): 703-11. |
[24] | Lovinger DM, Zhou Q. Trichloroethanol potentiation of 5-hydroxytryptamine3 receptor-mediated ion current in nodose ganglion neurons from the adult rat. J Pharmacol Exp Ther. 1993; 265 (2): 771-6. |
[25] | Peoples R W, Weight F F. Trichloroethanol potentiation of gamma-aminobutyric acid-activated chloride current in mouse hippocampal neurones. Br J Pharmacol. 1994; 113 (2): 555–563. |
[26] | M. D. Krasowski, N. L. Harrison. General anaesthetic actions on ligand-gated ion channels. Cell Mol Life Sci. 1999; 55 (10): 1278–1303. |
[27] | AK Salous, H Ren, KA Lamb, X-Q Hu, RH Lipsky, RW Peoples Differential actions of ethanol and trichloroethanol at sites in the M3 and M4 domains of the NMDA receptor GluN2A (NR2A) subunit. Br J Pharmacol. 2009; 158 (5): 1395–1404. |
[28] | Van Dam EA, van der Harst JE, ter Braak CJ, Tegelenbosch RA, Spruijt BM, Noldus LP. An automated system for the recognition of various specific rat behaviours. J Neurosci Methods. 2013; 218 (2): 214-24. |
[29] | Stephen MC, Mathew J, Varghese AM, Kurien M, Mathew GA. A Randomized Controlled Trial Comparing Intranasal Midazolam and Chloral Hydrate for Procedural Sedation in Children. Otolaryngol Head Neck Surg. 2015; 153 (6): 1042-50. |
[30] | Adams DA, McClelland RJ, Houston HG, Gamble WG. The effects of diazepam on the auditory brain stem responses. Br J Audiol. 1985; 19 (4): 277-80. |
[31] | Schwender D, Klasing S, Madler C, Pöppel E, Peter K. Effects of benzodiazepines on mid-latency auditory evoked potentials. Can J Anaesth. 1993; 40 (12): 1148-54. |
[32] | Scheller BC, Daunderer M, Pipa G. General anesthesia increases temporal precision and decreases power of the brainstem auditory-evokedresponse-related segments of the electroencephalogram. Anesthesiology. 2009; 111 (2): 340-55. |
[33] | Hyson RL, Sadler KA. Differences in expression of GABAA receptor subunits, but not benzodiazepine binding, in the chick brainstemauditory system. J Mol Neurosci. 1997; 8 (3): 193-205. |
[34] | Cai R, Caspary DM. GABAergic inhibition shapes SAM responses in rat auditory thalamus. Neuroscience. 2015; 299: 146-55. |
[35] | Nobre MJ, Cabral A, Brandão ML. GABAergic regulation of auditory sensory gating in low- and high-anxiety rats submitted to a fear conditioning procedure. Neuroscience. 2010 29; 171 (4): 1152-63. |
[36] | Cao L, Bie X, Huo S, Du J, Liu L, Song W. Effects of diazepam on glutamatergic synaptic transmission in the hippocampal CA1 area of rats with traumatic brain injury. Neural Regen Res. 2014; 9 (21): 1897-901. |
[37] | Licata SC, Shinday NM, Huizenga MN, Darnell SB, Sangrey GR, Rudolph U, et al. Alterations in brain-derived neurotrophic factor in the mouse hippocampus following acute but not repeated benzodiazepine treatment. PLoS One. 2013; 8 (12): e84806. |
[38] | Davila JM, Reiss RA, Jensen OE, Proskin H. Chloral hydrate-diazepam: per os combination in treatment of disabled. N Y State Dent J. 1991; 57 (9): 45-7. |
[39] | Davila JM, Herman AE, Proskin HM, Vitale D. Comparison of the sedative effectiveness of two pharmacological regimens. ASDC J Dent Child. 1994; 61 (4): 276-81. |
[40] | Conway A, Rolley J, Sutherland JR. Midazolam for sedation before procedures. Cochrane Database Syst Rev. 2016 20; (5): CD009491. |
[41] | Lu J, Greco MA. Sleep circuitry and the hypnotic mechanism of GABAA drugs. J Clin Sleep Med. 2006; 2 (2): S19-26. |
[42] | Norman JL, Anderson SL. Novel class of medications, orexin receptor antagonists, in the treatment of insomnia - critical appraisal of suvorexant. Nat Sci Sleep. 2016 14; 8: 239-47. |
[43] | Ghazal P, Corsi M, Roth A, Faggioni F, Corti C, Merlo Pick E,et al. Paradoxical response to the sedative effects of diazepam and alcohol in C57BL/6J mice lacking the neuropeptide S receptor. Peptides. 2014; 61: 107-13. |
[44] | McCormack L, Chen JW, Trapp L, Job A. A comparison of sedation-related events for two multiagent oral sedation regimens in pediatric dental patients. Pediatr Dent. 2014; 36 (4): 302-8. |
[45] | Hijazi OM, Ahmed AE, Anazi JA, Al-Hashemi HE, Al-Jeraisy MI. Chloral hydrate versus midazolam as sedative agents for diagnostic procedures in children. Saudi Med J. 2014; 35 (2): 123-31. |
[46] | Maheras KJ, Gow A. Increased anesthesia time using 2,2,2-tribromoethanol-chloral hydrate with low impact on mouse psychoacoustics. J Neurosci Methods. 2013; 219 (1): 61-9. |
[47] | Reynolds J, Rogers A, Capehart S, Manyang P, Watcha MF. Retrospective Comparison of Intranasal Dexmedetomidine and Oral Chloral Hydrate for Sedated Auditory Brainstem Response Exams. Hosp Pediatr. 2016; 6(3): 166-71. |
[48] | Reynolds J, Rogers A, Medellin E, Guzman JA, Watcha MF. A prospective, randomized, double-blind trial of intranasal dexmedetomidine and oral chloral hydrate for sedated auditory brainstem response (ABR) testing. Paediatr Anaesth. 2016; 26(3): 286-93. |
[49] | Anesthesia and Analgesia in Laboratory Animals. Second. San Diego, CA: Academic Press; 2008. Buetow BS, Chen LI, Maggio-Price L, Swisshelm K. Peritonitis in Nude Mice in a Xenograft Study. Contemp Top Lab Anim Sci. 1999; 38 (6): 47–49. |
[50] | Burnett HF, Lambley R, West SK, Ungar WJ, Mireskandari K. Cost-effectiveness analysis of clinic-based chloral hydrate sedation versus general anaesthesia for paediatric ophthalmological procedures. Br J Ophthalmol. 2015; 99 (11): 1565-70. |
APA Style
Hayder Mutter Al-Kuraishy, Maryam Mohammed Hammed, Haider W. Alsarhan. (2016). Clinical Significant Effect of Chloral Hydrate: Diazepam Combination in the Induction of Sedation During Auditory Brainstem Response in Children with Hearing Loss. International Journal of Psychological and Brain Sciences, 1(2), 32-39. https://doi.org/10.11648/j.ijpbs.20160102.13
ACS Style
Hayder Mutter Al-Kuraishy; Maryam Mohammed Hammed; Haider W. Alsarhan. Clinical Significant Effect of Chloral Hydrate: Diazepam Combination in the Induction of Sedation During Auditory Brainstem Response in Children with Hearing Loss. Int. J. Psychol. Brain Sci. 2016, 1(2), 32-39. doi: 10.11648/j.ijpbs.20160102.13
AMA Style
Hayder Mutter Al-Kuraishy, Maryam Mohammed Hammed, Haider W. Alsarhan. Clinical Significant Effect of Chloral Hydrate: Diazepam Combination in the Induction of Sedation During Auditory Brainstem Response in Children with Hearing Loss. Int J Psychol Brain Sci. 2016;1(2):32-39. doi: 10.11648/j.ijpbs.20160102.13
@article{10.11648/j.ijpbs.20160102.13, author = {Hayder Mutter Al-Kuraishy and Maryam Mohammed Hammed and Haider W. Alsarhan}, title = {Clinical Significant Effect of Chloral Hydrate: Diazepam Combination in the Induction of Sedation During Auditory Brainstem Response in Children with Hearing Loss}, journal = {International Journal of Psychological and Brain Sciences}, volume = {1}, number = {2}, pages = {32-39}, doi = {10.11648/j.ijpbs.20160102.13}, url = {https://doi.org/10.11648/j.ijpbs.20160102.13}, eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijpbs.20160102.13}, abstract = {Hearing loss is the most common sensory disability in the world, hearing loss should be early diagnosed and treated since; it leads to speech and language disorders. Auditory brainstem response (ABR) or Auditory evoked potential (AEP) is a neurologic test done by an audiologist to measure auditory evoke potential. Different types of sedation levels are used during auditory brainstem response test. Therefore, the aim of present study was evaluation of the sedative effect of chloral hydrate during auditory brainstem response (ABR) on children with hearing problems. Randomized selection of 160 children with age ranged between 1-5 years with hearing disorders, they were divided into: Group A: Received 20 mg/Kg chloral hydrate orally. Group B: Received 20 mg/Kg chloral hydrate orally plus 0.5 mg/Kg diazepam rectally. Group C: Received 40 mg/Kg chloral hydrate orally. Group D: Received 40 mg/Kg chloral hydrate orally plus 0.5 mg/Kg diazepam rectally. Regarding ABR testing results, positive ABR test was superior in combined group compared to other groups p=0.005 whereas; negative ABR test was low in combined group compared to other groups p=0.006. At the end of ABR testing 118.52±9.88 of testing children in combined group completed the test compared to other groups p=0.0139 while; 98.21±7.22 of testing children in combined group not completed ABR test compared to other groups p=0.005.In conclusion, combined chloral hydrate plus diazepam give more significant sedative effect than chloral hydrate alone during ABR testing in children with hearing disorders.}, year = {2016} }
TY - JOUR T1 - Clinical Significant Effect of Chloral Hydrate: Diazepam Combination in the Induction of Sedation During Auditory Brainstem Response in Children with Hearing Loss AU - Hayder Mutter Al-Kuraishy AU - Maryam Mohammed Hammed AU - Haider W. Alsarhan Y1 - 2016/10/11 PY - 2016 N1 - https://doi.org/10.11648/j.ijpbs.20160102.13 DO - 10.11648/j.ijpbs.20160102.13 T2 - International Journal of Psychological and Brain Sciences JF - International Journal of Psychological and Brain Sciences JO - International Journal of Psychological and Brain Sciences SP - 32 EP - 39 PB - Science Publishing Group SN - 2575-1573 UR - https://doi.org/10.11648/j.ijpbs.20160102.13 AB - Hearing loss is the most common sensory disability in the world, hearing loss should be early diagnosed and treated since; it leads to speech and language disorders. Auditory brainstem response (ABR) or Auditory evoked potential (AEP) is a neurologic test done by an audiologist to measure auditory evoke potential. Different types of sedation levels are used during auditory brainstem response test. Therefore, the aim of present study was evaluation of the sedative effect of chloral hydrate during auditory brainstem response (ABR) on children with hearing problems. Randomized selection of 160 children with age ranged between 1-5 years with hearing disorders, they were divided into: Group A: Received 20 mg/Kg chloral hydrate orally. Group B: Received 20 mg/Kg chloral hydrate orally plus 0.5 mg/Kg diazepam rectally. Group C: Received 40 mg/Kg chloral hydrate orally. Group D: Received 40 mg/Kg chloral hydrate orally plus 0.5 mg/Kg diazepam rectally. Regarding ABR testing results, positive ABR test was superior in combined group compared to other groups p=0.005 whereas; negative ABR test was low in combined group compared to other groups p=0.006. At the end of ABR testing 118.52±9.88 of testing children in combined group completed the test compared to other groups p=0.0139 while; 98.21±7.22 of testing children in combined group not completed ABR test compared to other groups p=0.005.In conclusion, combined chloral hydrate plus diazepam give more significant sedative effect than chloral hydrate alone during ABR testing in children with hearing disorders. VL - 1 IS - 2 ER -