caa a22 4500 475848489 CHVBK 20180406123921.0 cr unu---uuuuu 170329e20000801xx s 000 0 eng 10.1007/s004050000234 doi (NATIONALLICENCE)springer-10.1007/s004050000234 Influence of volatile and intravenous anesthetics on the threshold of the acoustically evoked stapedius reflex [Elektronische Daten] [U. Bissinger, P. K. Plinkert, G. Sesterhenn, A. Grimm, G. Lenz] The influence of volatile and intravenous anesthetics on the threshold of the acoustically evoked stapedius reflex (SR) was studied prospectively in 45 patients undergoing elective ENT surgical procedures. After premedication with flunitrazepam the patients were randomly assigned to one of nine groups. Group I: 70% nitrous oxide (N2O) in oxygen (O2); Groups II-VII: induction of anesthesia with intravenous thiopental, followed by mask inhalation with 100% O2 and 1.13% halothane (Group II), 2.52% enflurane (Group III) or 1.73% isoflurane (Group IV); or 70% N2O in oxygen, and 0.44% halothane (Group V), 0.86% enflurane (Group VI) or 0.75% isoflurane (Group VII); Group VIII: intravenous midazolam and ketamine; and Group IX: intravenous midazolam and alfentanil. Tympanometry and ipsilateral and contralateral SR measurements were performed when the effects of the anesthetics had achieved a steady state. Flunitrazepam raised the SR threshold only slightly. Substances applied during inhalation anesthesia either markedly increased the threshold contralaterally more than ipsilaterally (thiopental, N2O), or suppressed the reflex completely (thiopental, all volatile anesthetics with or without N2O). Under intravenous anesthesia the reflex was always present. The midazolam-ketamine combination influenced the threshold bilaterally only slightly, while the midazolam-alfentanil combination led to a pronounced, contralaterally significant elevation of the threshold. Based on its minimal influence on the SR threshold, flunitrazepam is especially suitable for sedation and the midazolam-ketamine combination for anesthesia in audiological diagnostic procedures. Springer-Verlag Berlin Heidelberg, 2000 Key words Cochlear implant nationallicence Impedance audiometry nationallicence Benzodiazepines nationallicence Thiopental nationallicence Nitrous oxide nationallicence Volatile anesthesia nationallicence Ketamine nationallicence Alfentanil nationallicence Bissinger U. Department of Anesthesiology and Transfusion Medicine, Section for Anesthesiology, University of Tübingen Medical School, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany Tel.: +49-7071-2986622, Fax: +49-7071-295679, DE aut Plinkert P. K. Department of Otolaryngology, Head and Neck Surgery, University of Tübingen Medical School, Tübingen, Germany, DE aut Sesterhenn G. Department of Otolaryngology, Head and Neck Surgery, University of Tübingen Medical School, Tübingen, Germany, DE aut Grimm A. Department of Anesthesiology and Transfusion Medicine, Section for Anesthesiology, University of Tübingen Medical School, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany Tel.: +49-7071-2986622, Fax: +49-7071-295679, DE aut Lenz G. Institute for Anesthesiology and Intensive Care Medicine, Clinic Ingolstadt, Tübingen, Germany, DE aut https://doi.org/10.1007/s004050000234 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004050000234 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Bissinger U. Department of Anesthesiology and Transfusion Medicine, Section for Anesthesiology, University of Tübingen Medical School, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany Tel.: +49-7071-2986622, Fax: +49-7071-295679, DE aut NATIONALLICENCE 700 1- Plinkert P. K. Department of Otolaryngology, Head and Neck Surgery, University of Tübingen Medical School, Tübingen, Germany, DE aut NATIONALLICENCE 700 1- Sesterhenn G. Department of Otolaryngology, Head and Neck Surgery, University of Tübingen Medical School, Tübingen, Germany, DE aut NATIONALLICENCE 700 1- Grimm A. Department of Anesthesiology and Transfusion Medicine, Section for Anesthesiology, University of Tübingen Medical School, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany Tel.: +49-7071-2986622, Fax: +49-7071-295679, DE aut NATIONALLICENCE 700 1- Lenz G. Institute for Anesthesiology and Intensive Care Medicine, Clinic Ingolstadt, Tübingen, Germany, DE aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer