PMID- 27723018
OWN - NLM
STAT- MEDLINE
DCOM- 20170104
LR  - 20171116
IS  - 1833-3516 (Print)
IS  - 1833-3516 (Linking)
VI  - 46
IP  - 3
DP  - 2016 Sep
TI  - The effect of general anaesthesia and neuromuscular blockade on Eustachian tube 
      compliance: a prospective study.
PG  - 166-169
AB  - OBJECTIVE: The most common complications of hyperbaric oxygen treatment (HBOT) 
      are related to pressure changes on gas-containing cavities. Therefore, inability 
      to auto-inflate the middle ear may result in transient or permanent hearing loss. 
      However, it seems that middle ear barotrauma (MEBt) does not develop more often 
      in mechanically ventilated patients than in ambulatory patients. This might be 
      explained by deep sedation of these patients. Therefore, the aim of this study 
      was to determine whether anaesthesia and/or neuromuscular blockade can influence 
      Eustachian tube (ET) function. METHODS: Forty patients who were undergoing 
      surgery under general anaesthesia were enrolled in this prospective study. ET 
      function was evaluated by tympanography performed three times: before induction 
      of general anaesthesia (baseline), after induction with sufentanyl/propofol and 
      after full blockade was achieved with a long-acting neuromuscular blocking agent. 
      RESULTS: There were no differences in ear volume (P = 0.19) and ear pressure (P = 
      0.07). There was a significant variation in compliance on tympanography after the 
      induction of general anaesthesia (P = 0.009). Compared to the baseline, this 
      variation was characterized by an increase after induction of anaesthesia (24 +/- 
      7.13%, P < 0.01) and neuromuscular blockade (23 +/- 8.9%, P < 0.05). The difference 
      between after induction and after neuromuscular blockade was not statistically 
      significant (P = 0.13). DISCUSSION: The findings of this trial suggest that the 
      administration of hypnotic drugs associated with opioids improves ET compliance. 
      Therefore it may have favourable prophylactic effects on MEBt in ventilated 
      intensive care unit patients scheduled for HBOT.
FAU - Mungur, Akeelesh
AU  - Mungur A
AD  - Department of Anaesthesiology, Hopital de la Cavale Blanche, Laboratoire ORPHY, 
      EA 4324, Universite de Bretagne Occidentale 6 avenue Le Gorgeu, CS 93837, 29238 
      Brest Cedex, France. pierre.lafere@chu-brest.fr
FAU - Cochard, Guy
AU  - Cochard G
AD  - Unit of Hyperbaric Oxygen Therapy, Hopital de la Cavale Blanche
FAU - Ozier, Yves
AU  - Ozier Y
AD  - Department of Anaesthesiology, Hopital de la Cavale Blanche, Brest, France, 
      Laboratoire ORPHY, Universite de Bretagne Occidentale, Brest.
FAU - Lafere, Pierre
AU  - Lafere P
AD  - Department of Anaesthesiology, Hopital de la Cavale Blanche, Brest, France, Unit 
      of Hyperbaric Oxygen Therapy, Hopital de la Cavale Blanche, Laboratoire ORPHY, 
      Universite de Bretagne Occidentale, Brest.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - Australia
TA  - Diving Hyperb Med
JT  - Diving and hyperbaric medicine
JID - 101282742
RN  - 0 (Analgesics, Opioid)
RN  - 0 (Anesthetics)
RN  - 0 (Neuromuscular Blocking Agents)
RN  - 2GQ1IRY63P (Atracurium)
RN  - AFE2YW0IIZ (Sufentanil)
RN  - YI7VU623SF (Propofol)
SB  - IM
MH  - Acoustic Impedance Tests/methods
MH  - Analgesics, Opioid/*pharmacology
MH  - *Anesthesia, General
MH  - Anesthetics/*pharmacology
MH  - Atracurium/pharmacology
MH  - Eustachian Tube/*drug effects/physiology
MH  - Humans
MH  - Hyperbaric Oxygenation
MH  - *Neuromuscular Blockade
MH  - Neuromuscular Blocking Agents/*pharmacology
MH  - Propofol/pharmacology
MH  - Prospective Studies
MH  - Statistics, Nonparametric
MH  - Sufentanil/pharmacology
MH  - Surgical Procedures, Operative
OTO - NOTNLM
OT  - ENT
OT  - Tympanometry
OT  - ear barotrauma
OT  - middle ear
EDAT- 2016/10/11 06:00
MHDA- 2017/01/05 06:00
CRDT- 2016/10/11 06:00
PHST- 2016/06/29 00:00 [received]
PHST- 2016/07/01 00:00 [accepted]
PHST- 2016/10/11 06:00 [entrez]
PHST- 2016/10/11 06:00 [pubmed]
PHST- 2017/01/05 06:00 [medline]
PST - ppublish
SO  - Diving Hyperb Med. 2016 Sep;46(3):166-169.