Schaffartzik W, Hirsch J, Frickmann F, Kuhly P, Ernst A
Departments of Anesthesiology, Intensive Care Medicine and Pain Therapy, Hospital of the Free University of Berlin, Berlin, Germany.
Anesth Analg. 2000 Dec;91(6):1466-72. doi: 10.1097/00000539-200012000-00032.
Hearing loss has been described after spinal anesthesia. We examined the hearing in patients before and after spinal and general anesthesia by pure tone audiometry (LdB: 125-1500 Hz; HdB: 2000-8000 Hz). Tympanic membrane displacement analysis was used to noninvasively monitor the intralabyrinthine and intracranial pressure. Eighteen patients received spinal anesthesia (G(SA)); 19 patients general anesthesia (G(GA)). Pure tone audiometry and TMD data were obtained preoperatively ((0)) and postoperatively on day 1 ((1)) and 2 ((2)). The mean threshold differences (Delta) in LdB(10) and LdB(20) were significantly different in G(SA) compared with G(GA) (DeltaLdB(10) + 0.15+/-3.07 dB vs. -1.34+/-3.77 dB, P = 0.05; DeltaLdB(20) -0.54+/-2.24 dB vs. -2.45+/-3.39 dB, P<0.01). However, there were no differences in DeltaHdB(10) between G(SA) and G(GA), but in DeltaHdB(20) (-1.40+/-3.95 dB vs -5.12+/- 6.35 dB, P = <0.01). We found a significant correlation between the magnitude of intraoperative intravascular volume replacement and low-frequency hearing loss. Tympanic membrane displacement values were not different pre- and postoperatively. Hearing was impaired after spinal and general anesthesia. Low-frequency hearing loss was correlated with intraoperative volume replacement. Tympanic membrane recordings did not reveal significant changes.
脊髓麻醉后曾有听力丧失的报道。我们通过纯音听力测定法（LdB：125 - 1500Hz；HdB：2000 - 8000Hz）检查了患者在脊髓麻醉和全身麻醉前后的听力。采用鼓膜位移分析对迷路内和颅内压进行无创监测。18例患者接受脊髓麻醉（G(SA)）；19例患者接受全身麻醉（G(GA)）。在术前（(0)）、术后第1天（(1)）和第2天（(2)）获取纯音听力测定和鼓膜位移数据。与G(GA)相比，G(SA)中LdB(10)和LdB(20)的平均阈值差异（Delta）有显著不同（DeltaLdB(10) +0.15±3.07dB vs. -1.34±3.77dB，P = 0.05；DeltaLdB(20) -0.54±2.24dB vs. -2.45±3.39dB，P<0.01）。然而，G(SA)和G(GA)之间DeltaHdB(10)没有差异，但DeltaHdB(20)有差异（-1.40±3.95dB vs -5.12±6.35dB，P = <0.01）。我们发现术中血管内容量补充量与低频听力丧失程度之间存在显著相关性。鼓膜位移值术前和术后无差异。脊髓麻醉和全身麻醉后听力均受损。低频听力丧失与术中容量补充相关。鼓膜记录未显示显著变化。
