Thesis (M.Med. ( Anaesthesiology)) --University of Limpopo (Medunsa Campus), 2011 / Introduction: Multiple studies have described a variable incidence
of transient hearing loss (hypoacousis) from 0.4% to 40% after
subarachnoid block, especially in the low-frequencies range (125 –
500 Hz) (1, 2). The mechanism of transient hypoacousis is attributed
to leakage of cerebrospinal fluid, which leads to a decrease in
perilymph pressure within the cochlear.
Hypothesis: The study hypothesis was based on an assumption that
hearing loss is more frequent in young patients who undergo spinal
anaesthesia in comparison with elderly patients.
Objective:
1) To determine the incidence of hearing loss after spinal
anaesthesia in the young versus elderly patients.
Materials and Methods: Ninety-eight male patients (ASA 1 - 11)
scheduled for cystoscopy under spinal anaesthesia were recruited
for the study. Recruitment of patients for the study was age
dependent and was divided into two groups: One group (49
patients) had patients aged between 17 and 44 years (Group Y) and the other group had 49 patients aged between 45 and 77 years made
up group two (GROUP E). Subarachnoid injection at L3-4 was
performed using a standard 22-gauge Quincke spinal needle with
patients in the sitting position and 2,5 ml to 3 ml of 0.5% isobaric
bupivacaine was administered. Patients were evaluated on the day
before spinal anaesthesia by pure tone audiometry at three different
frequency sounds viz. 125 – 500 Hz (Low frequency), 500 – 2000
Hz (Speech frequency) and at 2000 – 4000 Hz (High frequency).
This assessment was repeated 48 hours after the spinal block was
given Statistical Analysis: Analysis was descriptive providing
information on the mean (or median) and standard deviation of the
variables for each of the two groups. The results of the audiometry
were analyzed using repeated measures analysis of variance and
transformation to p-value. Differences in outcomes of the study
between the two groups were recorded as being statistically
significant if p-value is ≤ 0.05.
Results: No patient from the two groups developed hearing loss
either at low or high frequencies. However, there was a statistically
significant improvement in audiometric results (p-value ranging from 0.0001 and 0.063) 48 hours post-surgery in the elderly group
as compared with patients in the younger group.
Conclusion: The study revealed no hearing loss post-spinal
anaesthesia in both groups. It did, however, show that the elderly
group have better hearing acuity at all three frequency levels of
sound compared to the younger group after spinal anaesthesia
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:ul/oai:ulspace.ul.ac.za:10386/3174 |
| Date | January 2011 |
| Creators | Mpholo, Lebogang Thateng |
| Contributors | Bhagwandass, D. R, Baloyi, B. J |
| Publisher | University of Limpopo ( Medunsa Campus) |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | 52 leaves |
| Relation |
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