Transcanal cochlear implantation under monitored anesthesia care.
OBJECTIVE
Given the associated risk of general anesthesia in elderly patients with cardiovascular disease, the authors set out to determine the feasibility of transcanal cochlear implantation under local anesthesia with monitored anesthesia care.


METHODS
A 70-year-old man with a history of coronary artery bypass grafting, diabetes mellitus, and an American Society of Anesthesiologists Class III cardiac status underwent cochlear implantation under local with monitored anesthesia care.


RESULTS
With the described technique and regimen of intravenous remifentanil and dexmedetomidine, the patient tolerated the 60-minute procedure without tachycardia, hyper- or hypotension, or cardiac ischemia.


CONCLUSIONS
Cochlear implantation using the pericanal electrode technique performed under local anesthesia with monitored anesthesia care is possible in patients at risk for undergoing general anesthesia for cochlear implantation.
Djalilian
Hamid R
HR
Department of Otolaryngology-Head and Neck Surgery, University of Illinois at Chicago, Chicago, Illinois, USA. skullbasesurgery@yahoo.com
Roy
Saswata
S
Benson
Aaron G
AG
Regala
Christopher
C
McDonald
Timothy B
TB
Leman
Tina
T
D000368:Aged; D000772:Anesthesia, Local; D018686:Anesthetics, Intravenous; D019929:Cochlear Implantation / Q000379:methods*; D001026:Coronary Artery Bypass; D020927:Dexmedetomidine; D048909:Diabetes Complications; D005240:Feasibility Studies; D034381:Hearing Loss / Q000150:complications / Q000601:surgery*; D006801:Humans; D006993:Hypnotics and Sedatives; D008297:Male; D008499:Medical Records; D016343:Monitoring, Intraoperative; D010880:Piperidines; D000077208:Remifentanil; D012665:Semicircular Canals
D018686:Anesthetics, Intravenous; D006993:Hypnotics and Sedatives; D010880:Piperidines; D020927:Dexmedetomidine; D000077208:Remifentanil