Zmiany progu słyszenia u chorych znieczulanych podpajęczynówkowo

Edyta Kotlińska-Hasiec¹, Andrzej Nestorowicz¹, Katarzyna Trela-Stachurska¹, Piotr Trojanowski², Marcin Szymański², Krystyna Kramek²

Summary
Background. Transient hearing loss is among the lesser known complications of spinal analgesia. The mechanism of this phenomenon is not fully understood, but it has been more frequently associated with the use of large bore needles. The purpose of this study was to estimate the effects of the design of spinal needles on auditory threshold. Methods. 30 adult patients receiving bupivacaine spinal anaesthesia for orthopedic and urologic procedures were randomly divided into 2 groups, depending on the design of needle used. In group A, punctures were made with 26 G Whitacre needles, while in the group B, punctures were made with 26 G Quincke needles. A pure tone audiometry test was performed before surgery, and at the second and third days after anaesthesia. Results. In 11 patients of group B, the auditory threshold increased by 15-45 dB within the frequencies of 200 Hz, 500 Hz and 1000 Hz, returning to normal within one week. Patients of group A were not affected. Conclusion. Transient hearing impairment was associated with the use of Quincke needles, probably related to the decrease in cerebrovascular fluid pressure after the dural puncture.

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