ANESTHESIA MANAGEMENT FOR COCHLEAR IMPLANTATIONS IN PEDIATRIC PATIENTS


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Abstract

For the time present, the cochlear implantation is a widely used method of the treatment of deafness and severe hearing impairment. The operation is time-consuming and requires a long stay of the child in the hospital. The placement of the cochlear implant (CI) is executed under general anesthesia through transosseous access. The executive work of the surgical and anesthetic teams is an integral part of the successful implementation of intraoperative CI testing, on the base of results of which, in the postoperative period, there will be carried out the initial adjustment of the speech processor. An anesthesiologist should create conditions that facilitate the use of nerve stimulators in the intraoperative period and in a timely manner prevent such common postoperative complications as nausea, vomiting, and dizziness. This article provides a review of the literature of domestic and foreign authors on the issues arising in anesthesiologists during the implementation of cochlear implantations and the ways of their solutions. It is considered what difficulties can arise during the installation and initial adjustment of CI, as well as what anesthesia complications are most frequent in operations of this type. After studying the results of the work of different authors, the initial adjustment of the CI in the anesthetic management under the control of BIS and TOF monitoring was concluded to be performed at a higher level, and the timely and targeted administration of various drugs, at certain stages of anesthesia, contributed to the decline of the complications rate in the postoperative period.

About the authors

M. S. Kalugina

National Medical Research Center of Children’s Health

Author for correspondence.
Email: margarita405@mail.ru
Russian Federation

A. E. Aleksandrov

National Medical Research Center of Children’s Health

Email: noemail@neicon.ru
Russian Federation

E. A. Alekseeva

National Medical Research Center of Children’s Health

Email: noemail@neicon.ru
Russian Federation

Yu. Yu. Rusetskiy

National Medical Research Center of Children’s Health; I.M. Sechenov First Moscow State Medical University

Email: noemail@neicon.ru
Russian Federation

References

  1. Darlong V.,Khanna P.,Baidya D.K.,Chandralekha,Pandey R.,Punj J.,Kumar R.,Sikka K. Perioperative complications of cochlear implant surgery in children. J Anesth. 2015; Feb; 29(1):126-30.
  2. Roland J.T.Jr., Cosetti M., Wang K.H., Immerman S., Waltzman S.B. Cochlear implantation in the very young child: Long-term safety and efficacy. Laryngoscope. 2009 Nov;119(11):2205-10.
  3. James A.L., Papsin B.C. Cochlear implant surgery at 12 months of age or younger. Laryngoscope. 2004 Dec;114(12):2191-5.
  4. Jöhr M., Ho A., Wagner C.S., Linder T. Ear surgery in infants under one year of age: its risks and implications for cochlear implant surgery. Otol Neurotol. 2008 Apr;29(3):310-3
  5. Habib M.G., Waltzman S.B., Tajudeen B., Svirsky M.A. Speech production intelligibility of early implanted pediatric cochlear implant users. Int J Pediatr Otorhinolaryngol. 2010;74:855-9.
  6. Rubinstein J.T. Paediatric cochlear implantation: prosthetic hearing and language development. Lancet. 2002 Aug 10;360(9331):483-5.
  7. Connor C.M., Craig H.K., Raudenbush S.W., Heavner K., Zwolan T.A. The age at which young deaf children receive cochlear implants and their vocabulary and speech-production growth: is there an added value for early implantation? Ear Hear. 2006 Dec;27(6):628-44.
  8. Королёва И. В., Жукова О. С., Зонтова О. В. Кохлеарная имплантация у детей младшего возраста. Новости оториноларингологии и логопатологии. 2002; 1: 12-24.
  9. Миронов П.И., Сергеев А.В. Анестезиологическое обеспечение кохлеарной имплантации у детей. Анестезиология и реаниматология. 2012, 1: 76-18.
  10. Schultz A., Berger F.A., Weber B.P., Grouven U., Niclaus O., Lüllwitz E., Schultz B. Intraoperative electrically elicited stapedius reflex threshold is related to the dosage of hypnotic drugs in general anesthesia. Ann Otol Rhinol Laryngol. 2003; 112(12).
  11. Pedersen C.B., Jochumsen U., Madsen S., Koefoed-Nielsen B., Johansen L.V. Results and experiences with 55 cochlear implantations. Ugeskr Laeger. 2000 Oct 2;162(40):5346-50.
  12. Диаб Х.М., Дайхес Н.А., Юсифов К.Д., Пащинина О.А., Кондратчиков Д.С., Умаров П.У., Кузнецов А.О. Осложнения кохлеарной имплантации. Анналы хирургии. 2015; 4: 5-8
  13. Baidya D.K., Dehran М. Anaesthesia for cochlear implant surgery. Trends in Anaesthesia and Critical Care. 2011; 1(2):90-4.
  14. Chakrabarty A.,Tarneja V.K.,Singh V.K.,Roy P.K.,Bhargava A.K.,Sreevastava D.K. Cochlear Implant : Anaesthesia Challenges. Med J Armed Forces India. 2004; 60(4):351-7.
  15. Г.Г. Прокопьев, Л.Е. Цыпин. Анестезия в детской практике: учебное пособие. Под ред. проф. В.В. Лазарева. М.: МЕДпресс-информ, 2016. 552,441-2
  16. Clark G.M., Cowan R.S.C., Dowell R.C., editors. Cochlear implantation for infants and children, Singular Publishing Group, San Diego;1997:71-110.
  17. Yeh J.S., Mooney K.L., Gingrich K., Kim J.T., Lalwani A.K. Anesthetic complications in pediatric patients undergoing cochlear implantation. Laryngoscope. 2011; Oct;121(10):2240-10.
  18. Hawksworth С., Ravury S. An audit of anesthesia safety in a pediatric cochlear implantation program. Paediatr Anaesth. 2015; 25(6):630-5.
  19. Cox R.G., Nemish U., Ewen A., Crowe M.J. Evidence-based clinical update: does premedication with oral midazolam lead to improved behavioural outcomes in children? Can J Anaesth. 2006 Dec; 53(12):1213-9.
  20. Bajwa S.J., Kulshrestha A. The cochlear implantation surgery: A review of anesthetic considerations and implications. International Journal of Health and Allied Sciences, 2013(4), 225-9.
  21. Jana J.J., Vaid N., Shanbhag J. Effect of total intravenous anaesthesia on intraoperative monitoring of cochlear implant function in paediatric patients. Cochlear Implants Int. 2013; 14(3):169-73
  22. Пашков А.В., Дайхес Н.А., Пронин А.Е., Куян С.М., Юнусов А.С., Яблонский С.В., Рязанов В.Б., Белоконь А.Н. Способ интраоперационного программирования параметров речевого процессора системы кохлеарной имплантации. Тип: патент на изобретение, 2011 г., Россия
  23. Eftekharian A., Amizadeh M., Mottaghi K., Safari F., Mahani M.H., Ranjbar L.A., Abdi A., Mokari N. Effect of depth of general anesthesia on the threshold of electrically evoked compound action potential in cochlear implantation. Eur Arch Otorhinolaryngol. 2015 Oct;272(10):2697-701.
  24. Schultz B., Beger F.A., Weber B.P., Niclaus O., Lüllwitz E., Grouven U., Schultz A. Influence of EEG monitoring on intraoperative stapedius reflex threshold values in cochlear implantation in children. Paediatr Anaesth. 2003;13(9):790-6.
  25. Wilhelm W1, Kreuer S, Larsen R; Narcotrend-Studiengruppe. Narcotrend EEG monitoring during total intravenous anaesthesia in 4.630 patients. Anaesthesist. 2002 ;51(12):980-8.
  26. Ryazanov V.B., Diab Khassan M. , Daikhes N.A., Vainshtein D.P., Vainstein A.I., Kondratchikov D.S., Siraeva A.R., Pashchinina O.A. Peculiarities of anesthesia during cochlear implantation in pediatrics. Russian Journal of Anaesthesiology and Reanimatology, 2016;4 - 61.
  27. Suresh S., Barcelona S.L., Young N.M., Heffner C.L., Coté C.J. Does a preemptive block of the great auricular nerve improve postoperative analgesia in children undergoing tympanomastoid surgery? Anesth Analg. 2004 Feb;98(2):330-3
  28. Hamerschmidt R., Mocellin M., Gasperin A., Faria J., Trevizan G., Wiemes G. Local anesthesia for cochlear implant surgery: a possible alternative. Braz. J. Otorhinolaryngol. 2010; 76 (5): 561-4.
  29. Crawford M.W., White M.C., Propst E.J., Zaarour C., Cushing S., Pehora C., James A.L., Gordon K.A., Papsin B.C. Dose-dependent suppression of the electrically elicited stapedius reflex by general anesthetics in children undergoing cochlear implant surgery. Anesth Analg. 2009; May; 108(5):1480-7.
  30. Gnadeberg D., Battmer R.D., Lüllwitz E., Laszig R., Dybus U., Lenarz T. Effect of anesthesia on the intraoperative elicited stapedius reflex. Laryngorhinootologie. 1994 Mar;73(3):132-5.
  31. Sivam S.K., Syms C.A., King S.M., Perry B.P. Consideration for routine outpatient pediatric cochlear implantation: A retrospective chart review of immediate post-operative complications. Int J Pediatr Otorhinolaryngol. 2017 ;94:95-99.
  32. Makhdoum M.J., Snik A.F., Stollman M.H., de Grood P.M., van den Broek P. The influence of the concentration of volatile anesthetics on the stapedius reflex determined intraoperatively during cochlear implantation in children. Am J Otol. 1998 ;19(5):598-603.
  33. Bissinger U., Plinkert P.K., Sesterhenn G., Grimm A., Lenz G. Influence of volatile and intravenous anesthetics on the threshold of the acoustically evoked stapedius reflex. Eur Arch Otorhinolaryngol. 2000;257(7):349-54.
  34. Banoub M., Tetzlaff J.E., Schubert A. Pharmacologic and physiologic influences affecting sensory evoked potentials: implications for perioperative monitoring. Anesthesiology. 2003 Sep;99(3):716-37.
  35. Alhowary A.A., Radaideh K., Rusan A., Hani D.B., Khraise W., Omari A., Alzoubi F. 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. J Clin Anesth. 2017 ;36:80-3.
  36. Yeo J., Jung J., Ryu T., Jeon Y.H., Kim S., Baek W. Antiemetic efficacy of dexamethasone combined with midazolam after middle ear surgery. Otolaryngol Head Neck Surg. 2009 ;141(6):684-8.
  37. Harry R.F. Powell, Richard G. Rowlands, Jeremy A. Lavy, Anthony Wright. Day-case pediatric middle ear surgery: From myringoplasty to bilateral cochlear implantation. International Journal Pediatric Otorhinolaryngology. 2010 ;74(7):803-6.
  38. Mc.Junkin J., Jeyakumar A. Complications in pediatric cochlear implants. Am J Otolaryngol. 2010 Mar-Apr;31(2):110-3. doi: 10.1016/j.amjoto.2008.11.012. Epub 2009 Mar 27.
  39. Cosetti M., Roland J.T. Jr. Cochlear implantation in the very young child: issues unique to the under-1 population. Trends Amplif. 2010 ;14(1):46-57.
  40. Semaan M.T., Fredman E.T., Shah J.R., Fares S.A., Murray G.S., Megerian C.A. Surgical duration of cochlear implantation in an academic university-based practice. Am J Otolaryngol. 2013 ;34 (5):382-7.
  41. Broomfield SJ, , Wild DC, Murphy J, O’Donoghue GM; Writing for the UK National Paediatric CI Surgical Audit Group. Results of a prospective surgical audit of bilateral paediatric cochlear implantation in the UK. Cochlear Implants Int. 2014 ;15(5):246-53.
  42. Venail F., Sicard M., Piron J.P., Levi A., Artieres F., Uziel A., Mondain M. Reliability and complications of 500 consecutive cochlear implantations. Arch Otolaryngol Head Neck Surg. 2008 ;134(12):1276-81.

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