Cochlear implantation is associated with minimal anesthetic risk in the elderly

Most elderly patients with severe to profound hearing loss are not being referred for cochlear implantation (CI), the only intervention to significantly improve hearing and quality of life in this population. Possible concern over the risks of anesthetic in the elderly may be one of the foremost concerns. The authors investigated whether advanced age is a risk factor when undergoing general anesthesia for cochlear implantation.

Retrospective chart review.

A retrospective chart review was conducted at a tertiary academic referral center of 70 patients older than 70 years, who underwent CI with general anesthesia between 1984 and 2007, and for whom anesthesia records were available. Patients were divided into anesthetic risk group A (American Society of Anesthesiologist classification [ASA] I/II) and B (ASA III/IV). Intraoperative and postoperative anesthesia-related complications were identified.

Of the 70 patients, 44 were in group A and 26 were in group B, both with a mean age of 77. Four patients, one from group A and three from group B, required intraoperative pressors for blood pressure support. There were no anesthesia-related complications in group A, but there were three (12% of group B and 4% overall) in group B: delayed extubation, postoperative congestive heart failure, and urinary retention. There was no long-term morbidity or mortality.

General anesthesia is well tolerated by elderly patients undergoing cochlear implantation. Preexisting medical condition of the patient as defined by ASA is a better predictor of intraoperative and postoperative complication than age alone.