A general anaesthetic is not expected to cause or worsen tinnitus, but a spinal or epidural can rarely bring on low-pitched ringing with muffled hearing, and sudden hearing loss after any operation needs same-day assessment.
The evidence behind that is thin: mostly case reports and small studies. No study found for this article measured how often ordinary surgery starts or worsens tinnitus, but the literature does show where the real risks sit.
If your hearing has changed since the operation
The US National Institute on Deafness and Other Communication Disorders (NIDCD) describes sudden deafness as a rapid loss of hearing, at once or over a few days, often in one ear and sometimes with ringing. It advises treating it as a medical emergency: about half of people recover some or all of their hearing on their own, but delay can make treatment less effective.
- Get it assessed today if hearing in one or both ears has dropped or turned muffled since the operation. Sudden hearing loss explains what the assessment involves, and the when to seek care checker sorts which symptoms need a same-day visit.
- Say which anaesthetic you had. After a spinal, an epidural or a lumbar puncture, the cause may be a spinal fluid leak, and the authors of a 2026 case report point out that it is treated differently from ordinary sudden hearing loss.
- Mention any headache, especially one that is worse sitting or standing and eases when you lie down.
General anaesthesia and other operations: a handful of case reports
A 2004 review in the German journal Der Anaesthesist, written from a tinnitus clinic, concluded that no increase in how often tinnitus occurs, or how loud it is, should be expected after general anaesthesia. That is an expert review rather than a measured result, but nothing found for this article contradicts it.
Sudden hearing loss after an operation under general anaesthesia does happen, rarely enough that individual cases get published. A 1997 review in The Laryngoscope found only 15 cases in the English-language literature after general anaesthesia for surgery not involving the ear. Another 1997 review counted fewer than 20 after operations involving neither the ear nor heart bypass. About 30% of the patients reported to that point had improved significantly, and its authors raised the possibility that the association is spurious: an event this rare may sometimes simply coincide with an operation. A 2015 case report and literature review added that the permanent loss it can leave is something every surgeon should know about.
A 2019 series from New Delhi described three men aged 70 to 82 who lost hearing in one ear after spine surgery, though its summary does not say which anaesthetic they had; two received intravenous steroids, and none had recovered by the last follow-up.
Nitrous oxide, a gas used in general anaesthesia, raises the pressure in the air-filled middle ear. A 1976 report described four patients who lost hearing afterwards, but in a 2007 Serbian study of 58 patients the pressure rose significantly and hearing tests afterwards found no loss.
Heart surgery on bypass
Away from the ear, heart surgery on a heart-lung bypass machine is the operation most often linked to sudden hearing loss. In a series of about 7,000 bypass patients between 1969 and 1978, seven lost hearing in one ear immediately after the operation. Four improved, but none recovered completely. The authors judged emboli, tiny particles in the blood generated by the bypass, the most likely cause.
A 2025 systematic review gathered 16 studies that tested hearing after open-heart surgery, and 12 reported a significant difference between hearing before and after. Added together, the studies recorded hearing loss in 431 of 8,923 children and adults, or 4.8%, but the review did not combine the studies statistically because their methods were too varied, and "hearing loss" in them ranged from sudden deafness in one ear to small changes seen only on sensitive tests of inner-ear function. Its figure of about 0.1% for severe hearing loss comes from that same 7,000-patient series, so it is not separate confirmation. It counted hearing loss, not tinnitus, so it cannot say how often ringing follows heart surgery.
Spinal and epidural anaesthesia: the fluid-pressure route
A spinal anaesthetic is injected through the membrane that holds the fluid around the spinal cord. An epidural is placed just outside that membrane, and only goes through it by accident. The leading explanation for hearing changes after either is that fluid leaking from the puncture lowers the pressure, and the drop passes to the inner ear through a channel called the cochlear aqueduct. The 2004 review described a very rare but specific pattern after spinal anaesthesia: low-frequency tinnitus together with low-frequency hearing loss.
Small studies that tested hearing before and after a spinal suggest that a mild version is not unusual, and that the patient's age and the needle size may matter:
- In 50 men having hernia repair, a mild loss of 10 to 20 decibels at two or more pitches two days later was found in 52% of those aged 30 or under and 16% of those aged 60 or over. The authors called the loss transient and suggested that older people leak less fluid.
- In 28 patients having prostate surgery, a loss of 10 decibels or more at any pitch appeared in 13 of 14 given a thicker 22-gauge needle and 4 of 14 given a finer 26-gauge one. None had a headache, so the authors suggested a hearing test is a more sensitive sign of a leak.
- Not every study finds it. Among 60 women, 40 given a spinal for a caesarean section with either a rounded pencil-point or a cutting needle and 20 given an epidural in labour, none developed hearing loss.
Needle design matters for the headache: a 2017 meta-analysis of 25 randomised trials found post-dural puncture headache about two and a half times as common with cutting needles as with pencil-point ones.
When the ringing comes with a headache
A spinal fluid leak after a spinal, a lumbar puncture or an accidental puncture during an epidural can cause post-dural puncture headache, typically worse when upright; a leak with no procedure or injury behind it is spontaneous intracranial hypotension. In a Brazilian study of 640 people given spinal anaesthesia for planned surgery, 48 (7.5%) developed it, and 34 of those 48 (71%) had at least one other symptom from a list that included tinnitus, reduced hearing, neck stiffness, sensitivity to light and nausea.
In a 2026 case report from Zurich, a 39-year-old woman had a planned caesarean section under spinal anaesthesia, with a fine pencil-point needle placed at the first attempt. Afterwards she had muffled hearing in both ears, a constant rushing tinnitus, bouts of dizziness, and a headache at the back of the head that did not clearly change with position. A hearing test showed low-frequency loss in both ears. With rest, fluids, caffeine and pain relief, the headache and dizziness cleared within five days. Her hearing was normal at one week, and at six weeks the tinnitus was still there but much reduced.
The authors recommend asking about a recent spinal whenever someone has new low-frequency hearing loss, even without the classic positional headache. They write that, unlike sudden hearing loss, this condition has no place for steroids. The step up is an epidural blood patch, an injection of the patient's own blood into the epidural space to seal the leak, which they say guidelines suggest considering for severe symptoms such as hearing loss, and which should be considered readily if ear symptoms persist or worsen.
The evidence that a blood patch helps the ears is small. A 1995 Danish study tested hearing before and one hour after a blood patch in 16 people with severe post-dural puncture headache, and hearing had improved in 12. A 2018 case report from London describes a 40-year-old woman with severe tinnitus in both ears for six days after a lumbar puncture: her Tinnitus Handicap Inventory score fell from 84 to 16 three hours after a blood patch, and the tinnitus had gone within 24 hours.
Ringing that outlasts the headache still needs checking. In a 2025 case report from Turkey, a woman's headache after a spinal for caesarean section settled but her tinnitus persisted, and an MRI scan found collections of blood over both sides of the brain (subdural haematomas). She recovered with conservative care; the authors stress considering a bleed, with early imaging, when tinnitus accompanies this kind of headache.
Does it go away?
The hearing change mostly does, on the evidence available, but not always. The hernia-repair study described the hearing loss as transient, and the Zurich patient's hearing recovered within a week. No study has followed how long the tinnitus itself lasts across a group of patients, and the case reports range from days to years: the Zurich patient's ringing was still there at six weeks.
A 2020 case report from Dublin describes a 38-year-old woman whose labour epidural punctured the membrane unnoticed. Her headache resolved after two blood patches, but hearing loss and tinnitus were still present more than two years later.
Longer-term studies measured different things and give different pictures:
- A 2022 Toronto study compared 63 women who had an accidental puncture during a labour epidural with 63 matched women without one. Chronic hearing problems were reported by 14.3% against 1.6%, about 9 women against 1, but in yes-or-no survey answers rather than on a hearing test, and the design shows an association, not cause.
- A 2015 Swedish study tested hearing about five years after an accidental puncture treated with a blood patch, in 60 women. The difference from controls was less than 5 decibels, which the authors judged of minor clinical significance, though the women did report more difficulty following speech in noise.
A 2022 literature review identified only 21 published cases of hearing loss after lumbar puncture, spinal or epidural anaesthesia, and concluded that the problem is rare but calls for prompt investigation and treatment.
Ringing during a local anaesthetic injection
Ringing in the ears is one of the classic early warning signs of local anaesthetic systemic toxicity, a reaction to too much of the drug reaching the bloodstream, most often because some of it went into a blood vessel by accident. It comes alongside tingling around the mouth, a metallic taste, visual disturbance and agitation. A 2026 review notes that these early signs can progress to seizures and heart rhythm problems, and that sedatives given at the same time can mask them. They do not always come first: the review says up to 40% of cases start atypically, for example with heart signs before or alongside them. The 2004 review states that reversible tinnitus and hearing changes after local anaesthesia usually occur in this setting.
If any of these starts during or soon after a local anaesthetic, say so at once. The 2026 review advises watching for these signs for at least 30 minutes after an injection. Tinnitus after dental work covers the separate case reports of hearing loss after dental injections.
Medicines given around an operation
Some hospital drugs affect the ear in their own right. Loop diuretics such as furosemide usually cause only temporary hearing loss, and rarely permanent deafness except in severe kidney failure or when combined with other drugs that harm the ear. Ototoxic medications covers the other drugs with this effect, and aspirin and anti-inflammatory painkillers have their own article. If new ringing started with a new medicine, tell the prescriber rather than stopping it yourself.
If you already had tinnitus
No study found for this article measured whether existing tinnitus gets louder after an operation. Tinnitus flare-ups covers the common triggers of a temporary spike and what helps while one lasts.
If new or louder ringing lasts, how tinnitus is diagnosed describes what an assessment involves. Mention any accidental puncture you were told about, and any new medicines. If hearing has dropped, it is a same-day problem, whatever kind of anaesthetic you had.