Местная анестезия в хирургическом лечении пациентов с отосклерозом с IV степенью тугоухости и глухотой

Abstract

The article presents the material devoted to the actual problem-rehabilitation of patients with otosclerosis with sensorineural hearing loss (SNHL) IV degree and deafness with concomitant diseases. Material and methods: on the basis of Clinical Research Center of Otorhinolaryngology in the Department of ear diseases cochlear implantation (CI) was performed in 4 patients with otosclerosis and comorbidities under local infiltration anesthesia and intravenous sedation with Dexdor drug, which allowed to avoid the introduction of muscle relaxants. In the preoperative period, patients were carefully prepared for the operation, acquainted with each stage of the operation, with tables for intraoperative dialogue. CI was performed by the classical method. Each patient was also interviewed for all parameters (during surgery and in the early postoperative period). Results. After parenteral administration of the drug, the effect was achieved quickly enough, against the background of drug administration, blood pressure did not increase to high figures relative to the norm, aggravation of comorbidities was not noted, patients felt satisfactory, responded to all signs, answered questions by reading from the tables. In no case did patients feel pain during incision, soft tissue separation, boron machine operation, introduction of cochlear implant electrode array and its subsequent testing. Conclusions. The advantages of local anesthesia using the Dexdor drug include: less invasiveness of the procedure; the ability not to use muscle relaxants; cost savings; finding the patient in consciousness, which makes it possible to intraoperatively diagnose the implant and assess the patient’s auditory perception when giving signals; determine the presence or absence of pathological stimulation of the facial nerve; reducing the time of surgery.