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A retrospective cohort study of adverse event assessment during anesthesia‐related procedures for cochlear implant candidacy assessment and cochlear implantation in infants and toddlers
Author(s) -
Bruijnzeel Hanneke,
Wammes Emily,
Stokroos Robert J.,
Topsakal Vedat,
de Graaff Jurgen C.
Publication year - 2020
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/pan.13944
Subject(s) - medicine , adverse effect , cochlear implantation , cochlear implant , candidacy , anesthetic , anesthesia , propofol , retrospective cohort study , surgery , audiology , politics , political science , law
Background Cochlear implantation in children with sensorineural hearing loss is preferably performed at youngest age because early auditory input is essential to prevent neural plasticity decline. In contrast, the rate of anesthetic adverse events is increased during infancy. Therefore, to provide recommendations regarding an optimal pediatric implantation age, these possible anesthetic risks in infants need to be taken into account. Aims This study aimed at assessing the relation between the age at cochlear implant surgery and anesthetic and surgical adverse events. Secondary aims were to evaluate anesthetic and surgical adverse events in relation to (a) the number of preoperative anesthesia‐related procedures for cochlear implant candidacy assessment and (b) the anesthetic maintenance agent (total intravenous anesthesia versus inhalation anesthesia) during implantation. Methods We executed a retrospective cohort study to evaluate cochlear implantation performed in infants and toddlers between January 2008 and July 2015 in a tertiary pediatric center. We compared anesthetic and surgical adverse events between age‐at‐implantation (0‐12 and 12‐24 months of age) groups. Furthermore, we assessed whether anesthetic adverse events occurred during preoperative anesthesia‐related procedures for cochlear implant candidacy assessment. Results Forty‐six cochlear implantations were performed in 43 patients requiring 42 preoperative anesthesia‐related procedures. Nineteen cochlear implantations (41.3%) were performed during infancy. During implantation, the maintenance agent was either sevoflurane (n = 22) or propofol (n = 24). None of the patients encountered major anesthetic adverse events, whereas minor adverse events occurred during 34 cochlear implantations. Those attributed to surgery occurred following six implantations. Neither the age at implantation nor the anesthetic maintenance agent was significantly related to the occurrence of both types of adverse events. Conclusions Adverse events occur independent of the age at implantation, the number of anesthetic preoperative procedures, and the type of anesthetic maintenance agent in patients who received a cochlear implant before 24 months of age.