Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-24T02:19:50.207Z Has data issue: false hasContentIssue false

The incidence of hyperthermia during cochlear implant surgery in children

Published online by Cambridge University Press:  15 August 2017

A Schwartz
Affiliation:
Department of Anesthesiology and Critical Care, Soroka Medical Center and Ben Gurion University of the Negev, Beer Sheva, Israel
D Kaplan
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Soroka Medical Center and Ben Gurion University of the Negev, Beer Sheva, Israel
V Rosenzweig
Affiliation:
Department of Anesthesiology and Critical Care, Soroka Medical Center and Ben Gurion University of the Negev, Beer Sheva, Israel
M Klein
Affiliation:
Department of Anesthesiology and Critical Care, Soroka Medical Center and Ben Gurion University of the Negev, Beer Sheva, Israel
B F Gruenbaum
Affiliation:
Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut, USA
S E Gruenbaum
Affiliation:
Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut, USA
M Boyko
Affiliation:
Department of Anesthesiology and Critical Care, Soroka Medical Center and Ben Gurion University of the Negev, Beer Sheva, Israel
A Zlotnik
Affiliation:
Department of Anesthesiology and Critical Care, Soroka Medical Center and Ben Gurion University of the Negev, Beer Sheva, Israel
E Brotfain*
Affiliation:
Department of Anesthesiology and Critical Care, Soroka Medical Center and Ben Gurion University of the Negev, Beer Sheva, Israel
*
Address for correspondence: Dr Evgeni Brotfain, Department of Anesthesiology and Critical Care, Soroka Medical Center, Ben Gurion University of the Negev, Beer Sheva, Israel E-mail: [email protected]

Abstract

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.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Rosenberg, H. Clinical presentation of malignant hyperthermia. Br J Anaesth 1988;60:268–73CrossRefGoogle ScholarPubMed
2 Rosenberg, H, Pollock, N, Stowell, K. Malignant hyperthermia. Orphanet J Rare Dis 2007;2:21 CrossRefGoogle ScholarPubMed
3 Strazis, KP, Fox, AW. Malignant hyperthermia: a review of published cases. Anesth Analg 1993;77:297304 CrossRefGoogle ScholarPubMed
4 Anetseder, M, Hager, M, Muller, CR. Diagnosis of susceptibility to malignant hyperthermia by use of a metabolic test. Lancet 2002;359:1579–80CrossRefGoogle ScholarPubMed
5 Komazec, Z, Lemajić-Komazec, S, Dankuc, D, Vlaški, LJ, Kohlearna, KR. Cochlear implantation--risk and complications [in Serbian]. Med Pregl 2008;61:2730 Google ScholarPubMed
6 Mylanus, EA, Rotteveel, LJ, Leeuw, RL. Congenital malformation of the inner ear and pediatric cochlear implantation. Otol Neurotol 2004;25:308–17CrossRefGoogle ScholarPubMed
7 Sessler, DI. Temperature monitoring and perioperative thermoregulation. Anesthesiology 2008;109:318–38CrossRefGoogle ScholarPubMed
8 Cheney, FW. Should normothermia be maintained during major surgery? JAMA 1997;277:1165–6CrossRefGoogle ScholarPubMed
9 De Witte, J, Sessler, DI. Perioperative shivering: physiology and pharmacology. Anesthesiology 2002;96:467–84CrossRefGoogle ScholarPubMed
10 Insler, SR, Sessler, DI. Perioperative thermoregulation and temperature monitoring. Anesthesiol Clin 2006;24:823–37CrossRefGoogle ScholarPubMed
11 Sessler, DI. Perioperative heat balance. Anesthesiology 2000;92:578–96CrossRefGoogle ScholarPubMed
12 Hannenberg, AA, Sessler, DI. Improving perioperative temperature management. Anesth Analg 2008;107:1454–7CrossRefGoogle ScholarPubMed
13 Islander, G, Ording, H, Bendixen, D, Ranklev-Twetman, E. Reproducibility of in vitro contracture test results in patients tested for malignant hyperthermia susceptibility. Acta Anaesthesiol Scand 2002;46:1144–9CrossRefGoogle ScholarPubMed
14 Merdad, M, Crawford, M, Gordon, K, Papsin, B. Unexplained fever after bilateral superficial cervical block in children undergoing cochlear implantation: an observational study. Can J Anaesth 2012;59:2833 CrossRefGoogle ScholarPubMed