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Effects of Esmolol Induced Hypotensive Anaesthesia on Distortion Product Otoacoustic Emission

ABS TRACT Objective: The aim of this study is to investigate the effects of hypotensive anesthesia induced by esmolol on Distortion Product Otoacoustic Emission (DPOAE) and by this way its availability in cochlear monitoring. Material and Methods: This study, includes 25 patients between ages of 18-61 who were operated under general anesthesia. Bispectral Index (BIS) values were maintained in the 40-60 range by infusion of esmolol 50-300 mcg/kg/min, simultaneously with the induction of anesthesia. During surgery, esmolol infusion doses were set to maintain the mean arterial pressure (MAP) approximately 20% below the baseline. Hemodynamic and respiratory parameters and otoacoustic emission measurements were recorded at 0 min. before induction and 3 min., 10 min., and 20 min. after induction. Results: No statistically significant differences were observed in terms of DPOAE levels at 1500 Hz, 2000 Hz, 3000 Hz, 4000 Hz, 5000 Hz, and 6000 Hz. No statistically significant correlations were found between the changes of DPOAE levels and percentile changes of hemodynamic parameters according to the Bonferroni adjustment for 3 min., 10 min., and 20 min. time points when compared to zero minute time point. Conclusion: In this study, we found that esmolol-induced hypotensive anesthesia has no effect on the DPOAE response. This result is important in showing that the procedure we have been using in lateral skull base surgeries allow secure cochlear monitoring by providing hypotensive anesthesia.