RESEARCH REPORT Comparison of anesthetic agents on otoacoustic emissions in children: propofol vs ketamine Gurcan Gungor 1 , Pervin Sutas Bozkurt 1 , Haydar M. Yener 2 , Yetkin Z. Yilmaz 2 , Elif Sarı 2 , Ahmet Atas 2 , Selma Yilar 3 & Duygu Hayir 3 1 Department of Anesthesiology and Reanimation, Cerrahpasa Medical Faculty, University of Istanbul, Istanbul, Turkey 2 Department of Otorhinolaryngology, Cerrahpasa Medical Faculty, University of Istanbul, Istanbul, Turkey 3 Department of Audiology, Health Sciences Faculty, University of Istanbul, Istanbul, Turkey What is already known • Several animal and clinical studies have shown that the anesthetic agents, ketamine and propofol, have conflicting effects on otoacoustic emission measurements. What this article adds • Distortion-product otoacoustic emissions were reduced similarly by propofol and ketamine anesthesia. Lower false outcome ratio in transient evoked otoacoustic emissions made propofol a better option than ketamine. Keywords intravenous agents; otolaryngology; child; general anesthesia Correspondence Gurcan Gungor, Department of Anesthesiology and Reanimation, Fahrettin Kerim Gokay caddesi, No:186/5 Goztepe, Istanbul 34730, Turkey Email: gugungor@yahoo.com Section Editor: Jerrold Lerman Accepted 24 April 2016 doi:10.1111/pan.12936 Summary Background: Otoacoustic emission (OAE) tests are important evaluation tools for diagnosis of peripheral auditory pathology. Sedation or general anesthesia may be required for the performance of the OAE tests. The aim of this retrospective study was to compare the effects of anesthetic agents, propofol and ketamine, on OAEs in children. Methods: Fifty healthy children who underwent tonsillectomy and/or ade- noidectomy under general anesthesia were included in this study. Three anes- thesia induction protocols were defined for this study and the anesthesiologist applied his or her own choice. Transient evoked otoacoustic emissions (TEOAEs) and distortion-product otoacoustic emissions (DPOAEs) were automatically recorded in both ears of each patient prior to anesthetic (pre- drug) and following the loss of consciousness 5 min later (postdrug) by an audiologist blinded to the method of anesthesia. Acceptable TEOAEs were defined as signal noise ratio (S/N) of above 3 dB SPL (decibel sound pressure level) and DPOAEs of 6 dB SPL or above. Between-group and within-group comparisons and correlations were performed for statistical analysis. Results: Retrospective review of the anesthesia charts from 44 cases that completed the study showed that propofol, ketamine, and sevoflurane induc- tion protocols were used in 21, 18, and 5 cases, respectively. Measurements of 36 ears in the propofol group and 34 ears in the ketamine group were included in the final analysis. Postdrug TEOAE and DPOAE amplitudes were significantly lower than predrug amplitudes except at 8 kHz in the ketamine group. There was no significant statistical difference in postdrug DPOAE measurements between propofol and ketamine groups but a significant differ- ence was observed at 2 and 3 kHz of postdrug TEOAE measurements. TEOAE measurements were below 3 dB in 8 of 34 ears after ketamine and in 1 of 36 ears after propofol administration. There was a significant difference © 2016 John Wiley & Sons Ltd Pediatric Anesthesia 26 (2016) 752–758 752 Pediatric Anesthesia ISSN 1155-5645