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首页> 外文期刊>Acta Neurochirurgica >Adverse effects of topical papaverine on auditory nerve function.
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Adverse effects of topical papaverine on auditory nerve function.

机译：局部罂粟碱对听神经功能的不良影响。

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BACKGROUND: Papaverine hydrochloride is a direct-acting vasodilator used to manage vasospasm during various neurosurgical operations. Transient cranial nerve dysfunction has been described in a few cases with topical papaverine. This study supports previous reports and provides neurophysiological evidence of an adverse effect on the auditory nerve. METHODS: We conducted a retrospective review of 70 consecutive microvascular decompression operations and studied those patients who received topical papaverine for vasospasm. Topical papaverine was used as a direct therapeutic action to manage vasospasm in a total of 11 patients. The timing of papaverine application and ongoing operative events was reviewed relative to changes in neurophysiological recordings. Brainstem auditory evoked potentials (BAEPs) were routinely used to monitor cochlear nerve function during these operations. FINDINGS: A temporal relationship was found between topical papaverine and BAEP changes leading to complete waveform loss. Theaverage temporal delay between papaverine and the onset of an adverse BAEP change was 5 min. In 10 of 11 patients, BAEP waves II/III-V completely disappeared within 2 to 25 min after papaverine. Eight of these 10 patients had complete loss of BAEP waveforms within 10 min. One patient showed no recovery of later waves and a delayed profound sensorineural hearing loss. The average recovery time of BAEP waveforms to pre-papaverine baseline values was 39 min. CONCLUSIONS: Topical papaverine for the treatment of vasospasm was associated with the onset of a transient disturbance in neurophysiological function of the ascending auditory brainstem pathway. The complete disappearance of BAEP waveforms with a consistent temporal delay suggests a possible adverse effect on the proximal eighth nerve. Recommendations to avoid potential cranial nerve deficits from papaverine are provided.
机译：背景：盐酸罂粟碱是一种直接作用的血管扩张药，用于在各种神经外科手术中控制血管痉挛。少数情况下使用局部罂粟碱描述了短暂性颅神经功能障碍。这项研究支持以前的报告，并提供了对听神经不利影响的神经生理学证据。方法：我们对连续70次微血管减压手术进行了回顾性研究，并研究了接受局部罂粟碱治疗血管痉挛的患者。共有11例患者使用局部罂粟碱作为直接治疗血管痉挛的方法。相对于神经生理学记录的变化，回顾了罂粟碱应用的时间和进行中的手术事件。在这些手术中，通常使用脑干听觉诱发电位（BAEP）来监测耳蜗神经功能。发现：局部罂粟碱和BAEP变化之间存在时间关系，导致完全波形丢失。罂粟碱与不良BAEP改变发作之间的平均时间延迟为5分钟。在11名患者中的10名患者中，罂粟碱注射后2至25分钟内，BAEP II / III-V波完全消失。这10名患者中有8名在10分钟内完全丧失了BAEP波形。一名患者未见后来波的恢复，并延迟了严重的感音神经性听力丧失。 BAEP波形恢复到罂粟碱前基线值的平均时间为39分钟。结论：局部罂粟碱治疗血管痉挛与上行听性脑干通路的神经生理功能暂时性紊乱有关。具有持续时间延迟的BAEP波形完全消失提示对近端第八神经可能产生不利影响。提供了避免罂粟碱引起的潜在颅神经缺损的建议。

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