PMID- 32663339
OWN - NLM
STAT- MEDLINE
DCOM- 20210303
LR  - 20210303
IS  - 1531-4995 (Electronic)
IS  - 0023-852X (Linking)
VI  - 131
IP  - 3
DP  - 2021 Mar
TI  - Cochlear Implantation Under Local Anesthesia With Conscious Sedation in the 
      Elderly: First 100 Cases.
PG  - E946-E951
LID - 10.1002/lary.28853 [doi]
AB  - OBJECTIVE: To report the outcomes on a large series of elderly patients who 
      underwent cochlear implantation (CI) surgery under local anesthesia with 
      conscious sedation (LA-CS). METHODS: Retrospective chart review on 100 
      consecutive elderly patients (> 65 years) who underwent CI with LA-CS at a 
      tertiary care center between August 2013 and January 2020. An age-matched control 
      group of 50 patients who underwent CI with general anesthesia (GA) are used for 
      comparison. Outcomes measured included time in the operating room, time in the 
      postanesthesia care unit (PACU), and rate of adverse events. RESULTS: Cochlear 
      implant surgery under LA-CS was successfully performed in 99 (99%) patients. One 
      patient requiring conversion to GA intraoperatively. No patients in the LA-CS 
      group experienced cardiopulmonary adverse events; however, three patients (6%) in 
      the GA group experienced minor events including atrial fibrillation and/or demand 
      ischemia. Overnight observation in the hospital due to postoperative medical 
      concerns or prolonged wake-up from anesthesia was required in one patient (1%) 
      from the LA-CS cohort and 12 patients (24%) from the GA cohort. Perioperative 
      adverse events exclusive to the LA-CS group included severe intraoperative 
      vertigo (8%), temporary facial nerve paresis (3%), and wound infection (1%). The 
      average amount of time spent in the operating room was 37 minutes less for 
      procedures performed under LA-CS compared to GA (P < .05). The average amount of 
      time in recovery was similar for both groups (P > .05). CONCLUSION: Cochlear 
      implant surgery under LA-CS offers many benefits and is a safe, feasible, and 
      cost-effective alternative to GA when performed by experienced CI surgeons. LEVEL 
      OF EVIDENCE: 3 Laryngoscope, 131:E946-E951, 2021.
CI  - (c) 2020 The American Laryngological, Rhinological and Otological Society, Inc.
FAU - Connors, Joseph R
AU  - Connors JR
AD  - Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, 
      NY, USA.
FAU - Deep, Nicholas L
AU  - Deep NL
AUID- ORCID: 0000-0003-2445-7454
AD  - Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, 
      NY, USA.
FAU - Huncke, T Kate
AU  - Huncke TK
AD  - Department of Anesthesiology, Perioperative Care, and Pain Medicine, NYU Langone 
      Health, New York, NY, USA.
FAU - Roland, J Thomas Jr
AU  - Roland JT Jr
AD  - Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, 
      NY, USA.
LA  - eng
PT  - Journal Article
DEP - 20200714
PL  - United States
TA  - Laryngoscope
JT  - The Laryngoscope
JID - 8607378
RN  - 0 (Hypnotics and Sedatives)
RN  - 67VB76HONO (Dexmedetomidine)
RN  - 98PI200987 (Lidocaine)
SB  - IM
MH  - Administration, Topical
MH  - Aged
MH  - Aged, 80 and over
MH  - Anesthesia, General/*adverse effects/economics
MH  - Anesthesia, Local/adverse effects/economics/*methods
MH  - Cochlear Implantation/*adverse effects
MH  - Conscious Sedation/adverse effects/economics/*methods
MH  - Cost-Benefit Analysis
MH  - Dexmedetomidine/administration & dosage
MH  - Feasibility Studies
MH  - Female
MH  - Humans
MH  - Hypnotics and Sedatives/administration & dosage
MH  - Infusions, Intravenous
MH  - Injections, Subcutaneous
MH  - Lidocaine/administration & dosage
MH  - Male
MH  - Postoperative Complications/*epidemiology/etiology
MH  - Retrospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Cochlear implantation
OT  - conscious sedation
OT  - dexmedetomidine
OT  - geriatric surgery
OT  - hearing loss
OT  - local anesthesia
OT  - monitored anesthesia care
EDAT- 2020/07/15 06:00
MHDA- 2021/03/04 06:00
CRDT- 2020/07/15 06:00
PHST- 2020/03/18 00:00 [received]
PHST- 2020/05/04 00:00 [revised]
PHST- 2020/05/11 00:00 [accepted]
PHST- 2020/07/15 06:00 [pubmed]
PHST- 2021/03/04 06:00 [medline]
PHST- 2020/07/15 06:00 [entrez]
AID - 10.1002/lary.28853 [doi]
PST - ppublish
SO  - Laryngoscope. 2021 Mar;131(3):E946-E951. doi: 10.1002/lary.28853. Epub 2020 Jul 
      14.