title: Cochlear implant surgery with local anesthesia and sedation:  comparison with general anesthesia.
abstract: OBJECTIVE
  The purpose of this study is to evaluate the possibility of performing cochlear implant surgery under local anesthesia and sedation and to evaluate the response of patients under sedation at the time of neural telemetry, comparing the differences with general anesthesia.
  
  
  METHODS
  Twenty adult patients with bilateral sensorineural profound hearing loss submitted to cochlear implant surgery under general anesthesia and 20 patients under local anesthesia and intravenous sedation in the period from February 2011 to February 2012. The study was approved by the ethical committee of the institution.
  
  
  METHODS
  In both groups, we compared the costs of anesthesia, surgical time, time in recovery room, length of hospital stay, postoperative symptoms (pain, nausea, vomiting, and dizziness) and the degree of patient satisfaction. Besides, the reactions of the patients in the moment of the neural telemetry were also analyzed.
  
  
  METHODS
  The endpoint of this study is to establish the possibility of doing cochlear implant surgery with local anesthesia and sedation, discussing the differences and advantages over general anesthesia.
  
  
  RESULTS
  By t-test variables, time in recovery room, time in hospital stay, and cost of inpatient anesthesia differ between groups, being always lower in the group of local anesthesia with sedation. The same result can be obtained using the Wilcoxon test. The symptoms of nausea, vomiting, and dizziness did not differ in the 2 groups.
  
  
  CONCLUSIONS
  We conclude that the realization of the cochlear implant surgery under local anesthesia, and sedation is perfectly feasible with some advantages over general anesthesia. There were no problems during the neural telemetry performed by the time of the surgery in patients with local anesthesia with sedation.
authors.affiliation: Department of Ophthalmology-Otorhinolaryngology, Hospital de Clinicas, Federal University of Paraná, Brazil. rogeriohamer@hotmail.com
authors.forename: Rogério
authors.initials: R
authors.lastname: Hamerschmidt
authors.forename: Ana Tereza Ramos
authors.initials: AT
authors.lastname: Moreira
authors.forename: Gislaine Richter Minhoto
authors.initials: GR
authors.lastname: Wiemes
authors.forename: Sérgio Bernardo
authors.initials: SB
authors.lastname: Tenório
authors.forename: Elizabeth Milla
authors.initials: EM
authors.lastname: Tâmbara
mesh_terms: D000328:Adult; D000768:Anesthesia, General; D000772:Anesthesia, Local; D019929:Cochlear Implantation / Q000379:methods*; D016292:Procedural Sedation; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction