Propofol Infusion: The Anesthetic of Choice for Auditory Brainstem Response Testing

Published April 2022 | Anesthesia and Analgesia

When testing children for auditory brainstem response, using the anesthetic propofol is less likely to produce false positives for hearing loss compared to another commonly-used drug, sevoflurane.

That’s the key finding of a study analyzing the impact of general anesthesia on children who need auditory testing. The comparison was led by first author Ali Kandil, senior author John McAuliffe III, and colleagues.

Five audiologists reviewed 1,259 records involving patients tested in at least four intensities in each ear.

“False-positive ABR tests, produced by certain anesthetic agents, can have significant life-long impact and negative psychosocial and developmental implications,” McAuliffe says. “Sevoflurane produced more false positives for hearing loss and suggested more severe hearing loss than propofol.”

Since publication, this data was presented at the American Academy of Audiology conference in St. Louis. The paper also was chosen as the Pediatric Anesthesia Article of the Day by Myron Yaster, MD, a major figure in pediatric anesthesia.

“I often thought that any anesthesia for ABRs that produced immobility would work,” Yaster wrote. “So, when I initially saw this article about the best way to provide anesthesia for ABRs, I thought, ‘Really?’ Well, today’s PAAD presents convincing evidence that there really is a better way to do it.”

Word about the preferred agent is spreading. “Several colleagues have reached out from other institutions across the country asking for our data and inquiring about our experience,” Kandil says. “Several have informed me they are changing their practice based on our experience at Cincinnati Children’s and our paper.”