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Author Spotlight: Advancements in Impedance Monitoring for Cochlear Implant Surgery
Published on: August 4, 2023
The incidence of hyperthermia during cochlear implant surgery in children
A Schwartz1, D Kaplan2, V Rosenzweig1
1Department of Anesthesiology and Critical Care,Soroka Medical Center and Ben Gurion University of the Negev,Beer Sheva,Israel.
Insights
Pediatric patients undergoing cochlear implantation are at higher risk for developing anesthesia-related hyperthermia. This condition, sometimes presenting as malignant hyperthermia, requires careful monitoring during surgery.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Critical Care Medicine
Background:
- Inadvertent hyperthermia during anesthesia is a rare but serious complication.
- Severe hyperthermia cases were observed in pediatric patients during cochlear implantation anesthesia.
Purpose of the Study:
- To describe clinical characteristics of children with intra-operative hyperthermia during cochlear implantation.
- To investigate potential mechanisms and predisposing factors for hyperthermia in this cohort.
Main Methods:
- Retrospective review of anesthetic charts for patients under 18 years old.
- Study period: January 2006 - December 2009 at Soroka Medical Center, Israel.
- Control groups included patients undergoing mastoid and ophthalmic surgery.
Main Results:
- Cochlear implant surgery patients had a significantly higher incidence of hyperthermia (10%) compared to controls (0.7%, p < 0.05).
- Five of seven hyperthermia cases presented with tachycardia and hypercapnia, consistent with malignant hyperthermia.
- The study identified a higher susceptibility to hyperthermia in pediatric cochlear implant patients.
Conclusions:
- Patients undergoing cochlear implantation are susceptible to intra-operative hyperthermia.
- This study details hyperthermic events during pediatric cochlear implantation.
- Potential triggers for hyperthermia in this surgical context were explored.
Background:
Inadvertent hyperthermia during anaesthesia is a rare but life-threatening complication. We have encountered several cases of severe hyperthermia in paediatric patients undergoing anaesthesia for cochlear implantation.
Methods:
This study aimed to describe the clinical characteristics of children who developed hyperthermia while undergoing cochlear implantation, and to explore possible mechanisms and predisposing factors. The anaesthetic charts of all patients aged under 18 years who underwent cochlear implantation, or mastoid or ophthalmic surgery, between 1 January 2006 and 31 December 2009, at Soroka Medical Center in Beer Sheva, Israel, were reviewed. Patients undergoing mastoid and ophthalmic surgical procedures were used as controls.
Results:
A larger percentage of patients who underwent cochlear implant surgery (10 per cent) developed hyperthermia compared to controls (0.7 per cent, p < 0.05). In five of the seven cases, hyperthermia appeared in combination with tachycardia and hypercapnia, adhering to the clinical triad of malignant hyperthermia.
Conclusion:
Patients undergoing cochlear implantation are susceptible to developing intra-operative hyperthermia. This article describes the hyperthermic events that occur during paediatric cochlear implantation, and attempts to identify potential triggers of hyperthermia.
