Role of repeated epidural injections in preventing post-spinal hearing loss.
OBJECTIVE
To determine if epidural volume extension and continued postoperative epidural injections prevent hearing loss associated with a 23-gauge (G) Quincke spinal needle.


METHODS
Prospective, double blinded trial.


METHODS
Operating rooms.


METHODS
30 adult patients scheduled for lower abdominal or perineal surgery during spinal anesthesia.


METHODS
Patients were divided into two groups of 15 each. All patients received subarachnoid injection with a 23-G Quincke needle. While patients in Group S received a single-shot spinal, Group E patients underwent epidural catheter placement one intervertebral space above. The epidural catheter was bolused with 10 mL of normal saline followed by postoperative epidural boluses of local anesthetic for analgesia as needed.


METHODS
Patients' auditory function was evaluated by pure tone audiometry (frequencies of 250-8,000 Hz) on the day before and two days after receiving the spinal anesthesia.


RESULTS
Unilateral low-frequency hearing loss (500 Hz) was seen in Group S (P < 0.05). It was prevented by the repeated epidural injections as used in Group E.


CONCLUSIONS
Following spinal anesthesia, epidural volume extension with 10 mL of normal saline followed by epidural local anesthetic boluses titrated to adequate postoperative analgesia (6-8 mL each time) prevents post-spinal hearing loss.
Department of Anaesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Shahadra, Delhi-110095, India. drashatyagi@gmail.com
Asha
A
Tyagi
Utkarsh
U
Gupta
Anil
A
Kumar
Ashok Kumar
AK
Sethi
Medha
M
Mohta
D000293:Adolescent; D000328:Adult; D000767:Anesthesia, Epidural / Q000009:adverse effects* / Q000379:methods; D000775:Anesthesia, Spinal / Q000009:adverse effects* / Q000379:methods; D001309:Auditory Threshold; D004311:Double-Blind Method; D005260:Female; D034381:Hearing Loss / Q000517:prevention & control*; D006801:Humans; D007268:Injections, Epidural; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies