脊髓麻醉后听力丧失：不同输注溶液的影响。
Hearing loss after spinal anesthesia: the effect of different infusion solutions.
作者信息
Yildiz Tulay Sahin, Solak Mine, Iseri Mete, Karaca Burhan, Toker Kamil
机构信息
Department of Anesthesiology, School of Medicine, University of Kocaeli, Kocaeli, Turkey.
出版信息
Otolaryngol Head Neck Surg. 2007 Jul;137(1):79-82. doi: 10.1016/j.otohns.2007.02.018.
OBJECTIVE
We speculate that the preoperative volume replacement with a convenient solution may protect the inner ear function after spinal anesthesia.
METHODS
The patients were randomized in a single-blind fashion into two groups: group LR (n = 40) received lactated Ringer's and group GF (n = 40) received gelatin polysuccinate 4% (Gelofusine). Spinal anesthesia was performed with a 25 G Quincke needle and was given bupivacaine 0.5% 10 mg and fentanyl 25 microg. Audiograms were performed preoperatively and 2 days postoperatively.
RESULTS
The overall incidence of hearing loss was 7.5%. The hearing loss was unilateral in two and bilateral in four patients. Hearing loss occurred within the low-frequency range and the hearing thresholds returned to normal by the fifth postoperative day.
CONCLUSIONS
Although the incidence of hearing loss for the lactated Ringer's group was higher than the Gelofusine group, there was no statistically significant difference between the groups. For medicolegal and ethical reasons, patients should be informed about the possibility of hearing loss after spinal anesthesia.
目的
我们推测使用便捷溶液进行术前容量补充可能会在脊髓麻醉后保护内耳功能。
方法
患者以单盲方式随机分为两组：乳酸林格氏液组（LR组，n = 40）接受乳酸林格氏液，明胶聚琥珀酸酯4%组（GF组，n = 40）接受4%明胶聚琥珀酸酯（佳乐施）。使用25G Quincke针进行脊髓麻醉，并给予0.5%布比卡因10mg和芬太尼25μg。术前及术后2天进行听力图检查。
结果
听力损失的总体发生率为7.5%。2例患者听力损失为单侧，4例为双侧。听力损失发生在低频范围内，术后第5天听力阈值恢复正常。
结论
虽然乳酸林格氏液组听力损失的发生率高于佳乐施组，但两组之间无统计学显著差异。出于法医学和伦理学原因，应告知患者脊髓麻醉后存在听力损失的可能性。
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