Kelly D J, Walsh F, Norman G S, Cunningham A J
Department of Anaesthesia, Beaumont Hospital, Royal College of Surgeons in Ireland, Dublin.
Anesth Analg. 1999 May;88(5):1064-8. doi: 10.1097/00000539-199905000-00017.
Auditory evoked potentials are effected by benzodiazepines, as is cortical processing of auditory stimuli. The effect of benzodiazepines on auditory sensitivity has not, however, been studied. We designed the present study to investigate the effect of sedative doses of midazolam on pure tone and speech audiometry and on audiological reaction times in healthy volunteers. Thirty volunteers underwent baseline audiological assessment for pure tones and speech and had their audiological reaction times measured at 10 and 50 dB above their threshold hearing level at a frequency of 1 kHz. Subjects were then randomly assigned to one of two groups. Group A (n = 15) received midazolam (0.04 mg/kg) IV, and Group B (n = 15) received a similar volume of placebo IV. The audiological tests were repeated 5 min later, and performance was compared with baseline data. Scheffé post hoc tests were used to assess the significance of changes in each group. There was no pre- to posttest change in audiological performance in either the placebo group (P = 0.194) or the midazolam group (P = 0.957). Speech audiometry performance was likewise unaffected by midazolam (P = 0.154). Reaction time at the 10-dB and 50-dB sensation levels were both significantly prolonged after midazolam administration (P = 0.023 and P = 0.012, respectively). In this study, we demonstrate that sedation with midazolam (0.04 mg/kg) does not alter pure tone or speech audiometric thresholds, but it does significantly delay the reaction time to auditory stimuli. Medical practitioners should advise midazolam-sedated patients of their impaired reaction to auditory warning signals (e.g., traffic and car horns) as part of the day-ward discharge recommendations.
In this study, we demonstrate that sedation of healthy volunteers with the benzodiazepine midazolam, in the common clinical dosage, does not affect their hearing capability as measured by pure tone and speech audiometry. However, one's ability to react to auditory signals is impaired after midazolam, which may have implications for patients after day-case procedures.
听觉诱发电位受苯二氮䓬类药物影响，听觉刺激的皮质处理也受其影响。然而，苯二氮䓬类药物对听觉敏感性的影响尚未得到研究。我们设计了本研究，以调查镇静剂量的咪达唑仑对健康志愿者纯音和言语听力测定以及听力学反应时间的影响。30名志愿者接受了纯音和言语的基线听力学评估，并在1kHz频率下，于高于其听阈水平10dB和50dB时测量了他们的听力学反应时间。然后将受试者随机分为两组。A组（n = 15）静脉注射咪达唑仑（0.04mg/kg），B组（n = 15）静脉注射相同体积的安慰剂。5分钟后重复听力学测试，并将结果与基线数据进行比较。采用谢费事后检验来评估每组变化的显著性。安慰剂组（P = 0.194）和咪达唑仑组（P = 0.957）的听力学表现从测试前到测试后均无变化。言语听力测定表现同样不受咪达唑仑影响（P = 0.154）。咪达唑仑给药后，10dB和50dB感觉水平下的反应时间均显著延长（分别为P = 0.023和P = 0.012）。在本研究中，我们证明，静脉注射咪达唑仑（0.04mg/kg）进行镇静不会改变纯音或言语听力测定阈值，但会显著延迟对听觉刺激的反应时间。医生应建议接受咪达唑仑镇静的患者，作为日间病房出院建议的一部分，告知他们对听觉警告信号（如交通和汽车喇叭声）的反应受损情况。
在本研究中，我们证明，以常用临床剂量用苯二氮䓬类药物咪达唑仑对健康志愿者进行镇静，不会影响通过纯音和言语听力测定所测量的他们的听力能力。然而，咪达唑仑给药后，个体对听觉信号的反应能力受损，这可能对日间手术患者有影响。
