Mistry Sandeep G, Carr Simon, Martin Jane, Strachan David R, Raine Christopher H, Fyrmpas Georgios
a Yorkshire Auditory Implant Service , Bradford Royal Infirmary , Duckworth Lane, UK.
Cochlear Implants Int. 2017 May;18(3):180-185. doi: 10.1080/14670100.2017.1296986. Epub 2017 Mar 9.
Cochlear implantation (CI) under local anaesthetic (LA) has previously been shown to be a successful and safe option for a specific group of patients (e.g. elderly and significant co-morbidity). We aim to discuss our practice and obtain qualitative information about patient experience from our cohort of patients at the Yorkshire Auditory Implant Service (YAIS).
Retrospective chart review to include demographics, co-morbidities and physiological parameters were recorded and used to calculate P-POSSUM (Portsmouth Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity) scores. The Iowa Satisfaction with Anaesthesia Scale (ISAS) questionnaire was distributed to all patients who received CI under LA and subsequently analysed.
Seven patients received CI under LA at YAIS. This included five males and two females. The mean age was 79 years (range 26 -93). The mean P-POSSUM mortality and morbidity for this cohort was 2.4 and 34.9%, respectively. The average ISAS score was +1.72 (where range of -3 is completely dissatisfied and +3 is completely satisfied).
We discuss our cohort and show that patients receiving CI have a favourable experience when LA is used. CI under LA is a viable and safe option for more elderly patients and those who are deemed at high risk of morbidity or mortality associated with a general anaesthetic.
The data regarding validated patient experience obtained from this study can be used to help counsel patients that may be offered CI under LA.
先前已证明，对于特定患者群体（如老年人及合并严重疾病者），局部麻醉下的人工耳蜗植入术（CI）是一种成功且安全的选择。我们旨在讨论我们的做法，并从约克郡听觉植入服务中心（YAIS）的患者队列中获取有关患者体验的定性信息。
进行回顾性病历审查，记录人口统计学、合并症和生理参数，并用于计算P-POSSUM（朴茨茅斯生理和手术严重程度评分，用于枚举死亡率和发病率）评分。向所有在局部麻醉下接受人工耳蜗植入术的患者发放爱荷华麻醉满意度量表（ISAS）问卷，随后进行分析。
7名患者在YAIS接受了局部麻醉下的人工耳蜗植入术。其中包括5名男性和2名女性。平均年龄为79岁（范围26 - 93岁）。该队列的平均P-POSSUM死亡率和发病率分别为2.4%和34.9%。平均ISAS评分为+1.72（范围从-3表示完全不满意到+3表示完全满意）。
我们讨论了我们的队列，并表明使用局部麻醉时接受人工耳蜗植入术的患者有良好的体验。对于更多老年患者以及那些被认为与全身麻醉相关的发病或死亡风险较高的患者，局部麻醉下的人工耳蜗植入术是一种可行且安全的选择。
从本研究中获得的关于经过验证的患者体验的数据可用于帮助向可能接受局部麻醉下人工耳蜗植入术的患者提供咨询。
