Sedation for Brainstem Evoked Auditory Response (BEAR) Testing Using Intravenous Pentobarbital - Full Text View

Purpose

This is a retrospective chart review study (700 charts from 2002 to 2010)of children from 0 to 18 years of age who have undergone Brainstem Evoked Auditory Response (BEAR)testing using midazolam and pentobarbital protocol for moderate sedation. The specific aims of this study are two-fold:

to determine the efficacy of intravenous pentobarbital during BEAR testing in the pediatric population using a standardized protocol; and
to evaluate the incidence of adverse events (major and minor), paradoxical reaction and failed sedation and identify predictors for failure and adverse events if any.

Condition
Childrens 0 to 18 Years of Age Who Require Moderate Sedation


Study Type:	Observational
Study Design:	Time Perspective: Retrospective
Official Title:	Sedation for Brainstem Evoked Auditory Response (BEAR) Testing Using Intravenous Pentobarbital - A Retrospective Study

Resource links provided by NLM:

Drug Information available for: Pentobarbital sodium Pentobarbital

U.S. FDA Resources

Further study details as provided by Akron Children's Hospital:

Primary Outcome Measures:

Determine the efficacy of intravenous pentobarbital during BEAR testing in the pediatric population using a standardized protocol. [ Time Frame: 2002 through 2010 ] [ Designated as safety issue: No ]
Evaluate the incidence of adverse events (major and minor) [ Time Frame: 2002 through 2010 ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:

Evaluate the incidence of paradoxical reaction [ Time Frame: 2002 through 2010 ] [ Designated as safety issue: Yes ]
Evaluate the incidence of failed sedation [ Time Frame: 2002 through 2010 ] [ Designated as safety issue: Yes ]
Identify predictors for failure and adverse events, if any [ Time Frame: 2002 through 2010 ] [ Designated as safety issue: Yes ]


Enrollment:	416
Study Start Date:	January 2011
Study Completion Date:	July 2012
Primary Completion Date:	July 2012 (Final data collection date for primary outcome measure)

Detailed Description:

Sedation Protocol:

Versed: 0.1mg/kg IV
Induction: 2mg/kg IV in children <1 year; 3mg/kg IV in children >1year
Maintenance phase: 1mg/kg IV every 3 to 5 minutes with a maximal dose of 8mg/kg or 200 mg

Definition of terms:

Failed Sedation: A case in which a patient is inadequately sedated after receiving maximum required dosages such that the test cannot be completed.
Paradoxical Reaction: Also known as 'pentobarbital rage' is defined as a patient experiencing sustained, inconsolable, and severe irritability or combativeness. This can occur anywhere between 30 minutes after administration of pentobarbital to post recovery phase.
Prolonged Sedation: A case in which either the patient cannot be discharged 3 hours after administration of the last sedating medication. It could also be a case in which patient is not back to baseline in 24 hours.
Hypoxia: This is defined as a sustained decrease in oxygen saturation (>30 seconds) of more than 10% from baseline.
Time to goal sedation: Time in minutes from initial administration of midazolam to the achievement of adequate sedation of the patient/start of procedure.
Time to recovery: time in minutes from the last dose of pentobarbital to recovery of baseline status.
Time to discharge: Time in minutes from administration of midazolam to discharge of patient from recovery room.

Eligibility


Ages Eligible for Study:	up to 18 Years (Child, Adult)
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	Yes
Sampling Method:	Non-Probability Sample

Study Population

Children from 0 to 18 years of age undergoing BEAR testing using midazolam and pentobarbital protocol for moderate sedation.

Criteria

Inclusion Criteria:

Children from 0 to 18 years of age
undergoing BEAR testing using midazolam and pentobarbital protocol for moderate sedation

Exclusion Criteria:

Children greater that 18 years of age
Patients with incomplete data

Contacts and Locations

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01282112

Locations


United States, Ohio
Akron Children's Hospital
Akron, Ohio, United States, 44308

Sponsors and Collaborators

Akron Children's Hospital

Investigators


Principal Investigator:	Urmila Tirodker, MD	Akron Children's Hospital

More Information

Publications:

Mason KP, Zurakowski D, Karian VE, Connor L, Fontaine PJ, Burrows PE. Sedatives used in pediatric imaging: comparison of IV pentobarbital with IV pentobarbital with midazolam added. AJR Am J Roentgenol. 2001 Aug;177(2):427-30.

Mason KP, Zurakowski D, Connor L, Karian VE, Fontaine PJ, Sanborn PA, Burrows PE. Infant sedation for MR imaging and CT: oral versus intravenous pentobarbital. Radiology. 2004 Dec;233(3):723-8. Epub 2004 Oct 29.

Karian VE, Burrows PE, Zurakowski D, Connor L, Mason KP. Sedation for pediatric radiological procedures: analysis of potential causes of sedation failure and paradoxical reactions. Pediatr Radiol. 1999 Nov;29(11):869-73.

Strain JD, Campbell JB, Harvey LA, Foley LC. IV Nembutal: safe sedation for children undergoing CT. AJR Am J Roentgenol. 1988 Nov;151(5):975-9.


Responsible Party:	Akron Children's Hospital
ClinicalTrials.gov Identifier:	NCT01282112 History of Changes
Other Study ID Numbers:	101014
Study First Received:	January 21, 2011
Last Updated:	June 25, 2014
Health Authority:	United States: Institutional Review Board

Additional relevant MeSH terms:


Pentobarbital Adjuvants, Anesthesia Hypnotics and Sedatives Central Nervous System Depressants Physiological Effects of Drugs	GABA Modulators GABA Agents Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action

ClinicalTrials.gov processed this record on September 27, 2016