Anaesthesia for cochlear implant surgery

SummaryCochlear implant surgery is commonly performed in small children with impaired communication abilities. In the pre-operative assessment, anaesthesiologist should build up good rapport with the patients and familiarise them with in-the-OT procedures and identify various associated syndromes which have their individual anaesthetic considerations. Intraoperative goals are to maintain stable haemodynamics to provide immobile bloodless field, modulation of anaesthetic technique to allow facial nerve monitoring and to reduce interference with stapedius reflex testing. Average duration of surgery is three hours and blood loss is not much as to warrant transfusion. Reversal and extubation should be smooth to prevent coughing and bulking on the tube to avoid dislodgement on implant. Measures should be taken to prevent post-operative nausea-vomiting and adequate analgesia should be provided. Involvement of primary care providers during pre-operative assessment and their presence in the post-operative period improves communication and ensures comfort to the child.