术后3小时突发耳聋

qiqi

臂丛麻醉术后3小时突发阻滞侧耳聋,不能确定是否与麻醉有关

remifen

请详细介绍一下病例，这样太笼统了，大家没有讨论和学习的机会

dznn2438

Causes of Sudden Onset of Deafness
• Drug toxicity (ototoxicity) results from administration or application of a drug or chemical which either directly or indirectly destroys cochlear hair cells, resulting in hearing loss or even total deafness. Many of the same agents are vestibulotoxic, disrupting the sense of balance so that the animal has a head tilt and may walk in circles. The most common cause of ototoxicity is the group of drugs known as the aminoglycoside antibiotics, which includes gentamicin, kanamycin, neomycin, tobramycin, and others. At times these drugs are the only treatment for a life-threatening infection, but they must be used with caution. Also, no-longer-available ear cleaning solutions containing chlorhexidine and a variety of less common chemicals can cause deafness (see G.M. Strain: "Aetiology, prevalence and diagnosis of deafness in dogs and cats." British Veterinary Journal 152:17-36, 1996). Concurrent conditions, such as an on-going infection or topical steroids, may increase penetration of a topical agent into the inner ear, increasing its toxicity. Recovery after hearing loss does not occur.

• General anesthesia may cause bilateral deafness from unknown causes. In rare cases, animals awaken from anesthesia deaf in both ears, often following ear cleaning or teeth cleaning. It may be the case that the body shunts blood away from the cochlea during anesthesia to protect other critical organs, or that pressure or jaw positioning compresses the arterial supply to the cochlea. A similar outcome is noted in humans with ischemia of the vertebrobasilar artery. The inner ear is especially vulnerable to reduced blood flow because it has no collateral circulation and the tissues have very high energy metabolism. None of the cases I have seen or had reported to me have recovered hearing except for two cases that may have been conductive deafness. This reinforces the need for a good otic examination to rule out ear canal obstruction or middle ear infections. It is not known if unrecognized cases of unilateral deafness result from anesthesia, since this condition is usually not recognized by owners.

dznn2438

盐酸利多卡因注射液口腔局部麻醉致重度耳聋
Hearing loss following spinal anaesthesia with bupivacaine
A Case of Transient Hearing Loss after General Anesthesia with Nitrous Oxide
Acute Deafness After Spinal Anesthesia
HNO. 1999 Oct;47(10):907-11. Links
[Acute unilateral deafness and contralateral hearing loss following inguinal hernia repair under controlled anesthesia]

qiqi

患者男43岁,术前一般情况好,未常规检查听力,术前访视未发现听力异常,行锁骨内固定术,1%利多和3%的罗派混合液25毫升行臂丛颈丛联和阻滞臂丛20颈丛5术中平稳无异常,术毕诉突发阻滞侧耳聋,听力检查阻止侧重度对侧轻度耳聋

remifen

患者男43岁???还有3%的罗派混合液,浓度高了些把?但和术后3小时的突发耳聋也没有必然联系吧,而且是双侧,所以检查一下颅内情况还是比较需要的,请神经内科会诊一下把

t_sh_oooo

是不是有点局麻药中毒了？还是大脑供血不足了？