Acute reversible bilateral hearing loss after retrobulbar anesthesia
Oman Journal of Ophthalmology, vol.16, no.2, pp.366-369, 2023 (Scopus)
- Publication Type: Article / Article
- Volume: 16 Issue: 2
- Publication Date: 2023
- Doi Number: 10.4103/ojo.ojo_129_22
- Journal Name: Oman Journal of Ophthalmology
- Journal Indexes: Scopus, Academic Search Premier, Directory of Open Access Journals
- Page Numbers: pp.366-369
- Keywords: Brainstem anesthesia, lipid emulsion infusion, local anesthetic toxicity, retrobulbar block
- Bursa Uludag University Affiliated: Yes
Abstract
This is the first reported case who had bilateral reversible hearing loss after regional anesthesia (RA) without a procedural sedoanalgesia. Furthermore, 20% lipid emulsion infusion (LEI) was first used in the treatment of a patient with hearing loss as an indicator of impending brainstem anesthesia. The ophthalmologist had performed a retrobulbar block without any difficulties to a 55-year-old the patient who undergone pars plana vitrectomy. A combination of lidocaine and bupivacaine was injected slowly through a 23G, 1.5-inch needle. Few minutes later, the patient experienced sudden bilateral hearing loss and, subsequently, mental confusion and mild respiratory distress. Local anesthetic toxicity to the predominantly brainstem was the diagnosis. Consequently, 20% LEI was administered, and his hearing loss gradually improved within a few hours. Prompt intervention is crucial in case of severe systemic complications of RA. LEI might be beneficial to halt the deepening of brainstem toxicity.