Wang L P, Magnusson M, Lundberg J, Törnebrandt K
Department of Anesthesiology and Intensive Care, Lund University Hospital, Sweden.
Reg Anesth. 1993 May-Jun;18(3):162-5.
To determine the effect of spinal anesthesia using 26-gauge needles on hearing.
Eighteen male patients undergoing transurethral resection of the prostate (TURP) or other transurethral procedures under spinal or epidural anesthesia were studied prospectively to reveal possible auditory side effects of dural puncture or absorption of irrigation fluid to the blood stream. Measurement of auditory function by pure tone, Bekesy and speech audiometry, and measurement of serum concentrations of sodium, potassium, urea, and glucose were performed preoperatively and postoperatively. Clinical examination of cranial nerve functions was performed postoperatively.
No mean change in hearing ability was seen in any group. One patient had severe, transient, low-frequency hearing loss with simultaneous severe postdural puncture headache. A statistically significant postoperative fall in serum osmolarity was noted in the epidural TURP group.
Transient, severe hearing loss may still occur after spinal anesthesia using a 26-gauge needle. Minor hearing loss does not seem to be a problem with this needle size.
确定使用26号针进行脊髓麻醉对听力的影响。
前瞻性研究18例接受脊髓或硬膜外麻醉下行经尿道前列腺切除术(TURP)或其他经尿道手术的男性患者,以揭示硬脊膜穿刺或冲洗液吸收进入血流可能产生的听觉副作用。术前和术后通过纯音、贝凯西听力计和言语测听法测量听觉功能,并测量血清钠、钾、尿素和葡萄糖浓度。术后进行颅神经功能的临床检查。
任何组均未观察到听力能力的平均变化。1例患者出现严重、短暂的低频听力损失,同时伴有严重的硬脊膜穿刺后头痛。硬膜外TURP组术后血清渗透压有统计学意义的下降。
使用26号针进行脊髓麻醉后仍可能发生短暂、严重的听力损失。对于这种针的尺寸,轻微听力损失似乎不是问题。