Effect of total intravenous vs volatile anesthetics on intraoperatively acquired electrically evoked compound action potential in children undergoing cochlear implant surgery: A randomized prospective study.
OBJECTIVE
The purpose of the present study was to compare the effects of inhalational anesthesia to those of total intravenous anesthesia on intraoperative electrically evoked compound action potential (e-ECAP) thresholds in children undergoing cochlear implantation.


METHODS
Randomized prospective study.


METHODS
Tertiary referral teaching hospital.


METHODS
Forty children aged 6 months to 17years with bilateral severe-to-profound sensorineural hearing loss and undergoing cochlear implantation were enrolled in the study.


METHODS
Patients were randomly assigned (1:1 ratio) into 2 groups to receive inhalational or total intravenous anesthesia.


METHODS
The e-ECAP measurements were obtained with neural response telemetry software.


RESULTS
All electrodes showed lower e-ECAP thresholds under propofol, and results were statistically significant for the apical electrodes (P<.05). There was no statistical difference in the impedances between the 2 groups. Propofol minimally affected the e-ECAP. In contrast, the impedance was not affected by anesthesia.


CONCLUSIONS
Volatile anesthetics result in higher e-ECAP thresholds in children, suggesting that e-ECAP thresholds acquired during inhalational anesthesia overestimate auditory nerve stimulation levels, which may cause discomfort postoperatively and adversely affect the child's adaptation to the implant. We recommend the use of total intravenous anesthesia for the measurement of the e-ECAP thresholds during cochlear implant surgery.
Department of Anesthesiology, Faculty of Medicine, Jordan University of Science and Technology, PO Box 953, Irbid 21110, Jordan. Electronic address: aaalhowary@just.edu.jo.
Ala A
AA
Alhowary
Department of Anesthesiology, Faculty of Medicine, Jordan University of Science and Technology, PO Box 953, Irbid 21110, Jordan. Electronic address: elradk61@yahoo.com.
Khaled
K
El-Radaideh
Department of Anesthesiology, Faculty of Medicine, Jordan University of Science and Technology, PO Box 953, Irbid 21110, Jordan. Electronic address: anas19187@gmail.com.
Anas
A
Al-Rusan
Department of Anesthesiology, Faculty of Medicine, Jordan University of Science and Technology, PO Box 953, Irbid 21110, Jordan. Electronic address: dabanihani@just.edu.jo.
Diab Bani
DB
Hani
Department of Anesthesiology, Faculty of Medicine, Jordan University of Science and Technology, PO Box 953, Irbid 21110, Jordan. Electronic address: wnkhraise@just.edu.jo.
Wail
W
Khraise
Division of Otolaryngology, Department of Special Surgery, Faculty of Medicine, Jordan University of Science and Technology, PO Box 3030, Irbid 22110, Jordan. Electronic address: aialomari@just.edu.jo.
Ahmad
A
Al Omari
Division of Otolaryngology, Department of Special Surgery, Faculty of Medicine, Jordan University of Science and Technology, PO Box 3030, Irbid 22110, Jordan. Electronic address: firasz@just.edu.jo.
Firas
F
Alzoubi
D000293:Adolescent; D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D001309:Auditory Threshold; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000379:methods*; D003054:Cochlear Implants; D004311:Double-Blind Method; D005072:Evoked Potentials, Auditory / Q000187:drug effects*; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D008738:Methyl Ethers / Q000494:pharmacology; D016343:Monitoring, Intraoperative / Q000379:methods; D009609:Nitrous Oxide / Q000494:pharmacology; D015742:Propofol / Q000494:pharmacology; D011446:Prospective Studies; D000077149:Sevoflurane
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D000077149:Sevoflurane; D009609:Nitrous Oxide; D015742:Propofol
Anesthesia; Cochlear; Evoked potentialsImplants; General; Implants; Intravenous