Şahin Mehmet İlhan, Vural Alperen, Akın Aynur, Ketenci İbrahim, Ünlü Yaşar
Department of Otolaryngology, Erciyes University Faculty of Medicine, Kayseri, Turkey.
Department of Anesthesia, Erciyes University Faculty of Medicine, Kayseri, Turkey.
J Audiol Otol. 2019 Apr;23(2):89-95. doi: 10.7874/jao.2018.00311. Epub 2019 Mar 13.
Knowing the ototoxic potential of the agents used in medical treatments is important for the protection of hearing. Although we have knowledge regarding some effects of dexmedetomidine, which is an anesthetic-sparing drug, its influence over the hearing system has never been studied and is obscure yet. The aim of this study is to determine the effects of intravenous dexmedetomidine application during sevoflurane anesthesia on otoacoustic emissions (OAEs).
This prospective randomized study was performed on 60 patients (34 male, 26 female, mean age: 30.6±9.2 years) who were scheduled for an elective surgery under general anesthesia and the patients were enrolled and randomly divided into 2 groups. They received dexmedetomidine (Group D) or Saline (Group S) infusion during a standardized Sevoflurane anesthesia. Transient and distortion product OAEs were measured preoperatively and postoperatively (24th hour). OAE results were compared within and between groups.
In group D postoperative OAEs were lower than preoperative OAEs and postoperative levels of group S, especially at low frequencies (p<0.05).
Dexmedetomidine infusion affects the micromechanical function of cochlea especially in the low-frequency region. Dexmedetomidine should be carefully used during general anesthesia to avoid its probable harmful effects on cochlear micromechanics.
了解医学治疗中所用药物的耳毒性潜力对于听力保护至关重要。尽管我们已了解右美托咪定（一种麻醉辅助药物）的一些作用，但其对听觉系统的影响从未被研究过，目前仍不清楚。本研究的目的是确定在七氟醚麻醉期间静脉应用右美托咪定对耳声发射（OAE）的影响。
本前瞻性随机研究对60例计划在全身麻醉下进行择期手术的患者（34例男性，26例女性，平均年龄：30.6±9.2岁）进行，将患者纳入并随机分为2组。在标准化的七氟醚麻醉期间，他们接受右美托咪定（D组）或生理盐水（S组）输注。在术前和术后（第24小时）测量瞬态和畸变产物耳声发射。对组内和组间的耳声发射结果进行比较。
在D组中，术后耳声发射低于术前及S组术后水平，尤其是在低频区域（p<0.05）。
输注右美托咪定影响耳蜗的微机械功能，尤其是在低频区域。在全身麻醉期间应谨慎使用右美托咪定，以避免其对耳蜗微机械结构可能产生的有害影响。
