Our department has had 2 reported instances (reported to our Morbidity and Mortality Review Committee) of sensori-neural deafness following general anesthesia. Both patients were otherwise well, having 1-2 hour procedures (peripheral limb surgery for one, and laparotomy for the other) with no hearing loss pre-op. They reported partial deafness both worse in one ear than the other. referal to ENT  - opinion was sensori-neural deafness (not simple conductive) of fairly high grade in one ear in each patient. So far, each has lasted 6 weeks with no signs of resolution.

Has anybody else come across this?

I have a concern with MH.

Nowadays it is really easy to give a non-triggering anesthetic. If I get a patient with known MH, or a relative of an MH patient, or even anybody remotely suspected of MH (perhaps a vague history of getting "hot" during a previous GA), then I give them a propofol infusion. Easy. No need to do cumbersome, invasive muscle biopsy tests.

Well I think there is still the need to test. What we are ending up with is a generation of patients who are suspected of MH but not biopsy-proven MH. Sure we can give them all non-triggering GA's. But what happens next generation? Do we suspect all their relatives to be MH psoitive as well? How far do we suspect? Will the history of suspected MH get reliably transmitted within the family?

I think we are already seeing a group of patients that have such a vague history, because their relative were not tested. It is easy to envisage a relative of a suspected MH patient slipping through the system and not give the history and then get a volatile anesthetic.

We still need to test all suspected MH patients, if not pre-op, then certainly post-op (or ideally as aprt of their current operation).

Does anyone (else) use LMAs for endarterectomies?

Works a treat the 3 times of tried it. Got to get the surgeon used to it, as it does give a degree of fullness in the neck.