Hearing loss after spinal anesthesia: the effect of different infusion solutions.
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.
Yildiz
Tulay Sahin
TS
Department of Anesthesiology, School of Medicine, University of Kocaeli, Kocaeli, Turkey.
Solak
Mine
M
Iseri
Mete
M
Karaca
Burhan
B
Toker
Kamil
K
D000775:Anesthesia, Spinal / Q000009:adverse effects*; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold / Q000502:physiology; D002045:Bupivacaine / Q000008:administration & dosage; D004244:Dizziness / Q000209:etiology; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D005440:Fluid Therapy; D005500:Follow-Up Studies; D034381:Hearing Loss / Q000209:etiology* / Q000517:prevention & control; D006312:Hearing Loss, Bilateral / Q000209:etiology; D046088:Hearing Loss, Unilateral / Q000209:etiology; D006801:Humans; D007262:Infusions, Intravenous; D007552:Isotonic Solutions / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011097:Polygeline / Q000008:administration & dosage / Q000627:therapeutic use*; D011183:Postoperative Complications; D020250:Postoperative Nausea and Vomiting / Q000209:etiology; D000077325:Ringer's Lactate; D016037:Single-Blind Method
D007552:Isotonic Solutions; D000077325:Ringer's Lactate; D011097:Polygeline; D005283:Fentanyl; D002045:Bupivacaine