Anaesthesia and deep brain stimulation

Bindu, Barkha; Bithal, Parmod K.

doi:10.4103/2348-0548.190064

Cited by 5 publications

(7 citation statements)

References 34 publications

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“…DISCUSSION Deep brain stimulation is a procedure which presents many anesthetic challenges. These procedures tend to be long, the patients should be in supine position for this long duration, which causes cervical and back pain during and after the procedure (1). The presence of head frame, down sliding of the patient on the operative table with the head fixed and neck flexed complicate the situation DBs procedure especially for the airway management.…”

Section: Graphic 3 Mean Observer's Assessment Of Alertness and Sedatmentioning

confidence: 99%

“…Deep Brain Stimulation (DBS) is a minimally invasive procedure used for the treatment of neurological disorder such as Parkinson's Disease, movement disorders and certain psychiatric conditions (1). DBS has become an increasingly common procedure over the past few years due to technological evaluation and increasing experience.…”

Section: Introductionmentioning

confidence: 99%

“…Preoperative assessment, pre-anesthetic checkup must be done carefully and include general condition of the patient, psychiatric history, cognitive function, level of disability, risk factors for complications and response to medical treatment. Conscious sedation and efficient analgesia allow surgeon to do neurological examination (1). Use of propofol and dexmedetomidine infusion has been described for sedation.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Integrated Pulmonary Index monitoring during sedation for Deep Brain Stimulation

Özcan¹,

Berkel²

2018

Kocaeli Med J

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De er ri in n B Be ey yi in n S St ti im mü ül la as sy yo on nu u ((D DB BS S)) u uy yg gu ul la an na an n h ha as st ta al la ar rı ın n e en nt te eg gr re e p pu ul lm mo on ne er r i in nd de ex x ((I IP PI I)) m mo on ni it tö ör ri iz za as sy yo on nu u i il le e t ta ak ki ib bi i E Ev va al lu ua at ti io on n o of f I In nt te eg gr ra at te ed d P Pu ul lm mo on na ar ry y I In nd de ex x m mo on ni it to or ri in ng g d du ur ri in ng g s se ed da at ti io on n f fo or r D De ee ep p B Br ra ai in n S St ti im mu ul la at ti io on n

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Section: Graphic 3 Mean Observer's Assessment Of Alertness and Sedatmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of Integrated Pulmonary Index monitoring during sedation for Deep Brain Stimulation

Özcan¹,

Berkel²

2018

Kocaeli Med J

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“…Parkinson's disease is a chronic, progressive, neurodegenerative disease characterized by postural instability, rigidity, bradykinesia, resting tremor, anxiety, depression, and cognitive and autonomic dysfunction. Initial treatment is medical, and DBS can be planned when medical treatment is insufficient (3). The prominent features of DBS are that it is effective, nondestructive, easy to adapt, and reversible (4).…”

Section: Introductionmentioning

confidence: 99%

Derin Beyin Stimulatörü Uygulanan Hastalarda Skalp Bloğu ve İnfiltrasyon Anestezisinde Methemoglobinemi Riski

Onay¹,

Harbelioğlu²,

Vural³

et al. 2020

Osmangazi̇ Journal of Medicine

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The application of local anesthetics in areas with a high blood supply, such as scalp block, is more susceptible to systemic effects of local anesthetics such as methemoglobinemia because of the high absorption rate and the risk of intravascular injection. In this study, we aimed to evaluate the risk of methemoglobinemia by reviewing methemoglobin values after scalp block in patients with a deep brain stimulation (DBS) due to neurological diseases, especially Parkinson's.The study included 41 patients aged >18 years who were admitted between January 2017 and December 2018 for DBS and underwent regional anesthesia (n = 41). Patients were administered scalp block (n = 10) and infiltration anesthesia (n = 31). Using data from the patients' medical records, we statistically analyzed the patients' age, American Society of Anesthesiologists (ASA) status, gender, DBS indication, scalp block/infiltration anesthesia, highest methemoglobin level in arterial blood gas, pH, pO2, SpO2, and clinical symptoms.The indications for DBS were Parkinson's disease in 29 patients hyperreactivity, dystonia and tremor in the remaining patients. Furthermore, 33 patients were classified as ASA class II. The methemoglobinemia level was >2% in two patients who underwent scalp block and six patients who underwent infiltration anesthesia. However, there was no statistically significant difference in methemoglobin levels between scalp and infiltration anesthesia.In areas with high blood flow, such as the scalp, caution should be exercised in administering local anesthesia because of the patient's risk of developing methemoglobinemia, although there are no clinical findings on this topic.

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“…PD patients with severe anxiety, rigidity, and dystonia, or even respiratory difficulty because of a lack of medication are considered unable to tolerate awake DBS surgery (Hertel et al, 2006 ). These patients must undergo STN DBS surgery with either conscious sedation or general anesthesia (GA) (Bindu and Bithal, 2016 ). Major concerns about DBS surgery under GA are (1) the loss of some features in the microelectrode signal and (2) the inability to test stimulation.…”

Section: Introductionmentioning

confidence: 99%

Decreased Power but Preserved Bursting Features of Subthalamic Neuronal Signals in Advanced Parkinson's Patients under Controlled Desflurane Inhalation Anesthesia

Lin

Lai

et al. 2017

Front. Neurosci.

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Deep brain stimulation (DBS) surgery of the subthalamic nucleus (STN) under general anesthesia (GA) had been used in Parkinson's disease (PD) patients who are unable tolerate awake surgery. The effect of anesthetics on intraoperative microelectrode recording (MER) remains unclear. Understanding the effect of anesthetics on MER is important in performing STN DBS surgery with general anesthesia. In this study, we retrospectively performed qualitive and quantitative analysis of STN MER in PD patients received STN DBS with controlled desflurane anesthesia or LA and compared their clinical outcome. From January 2005 to March 2006, 19 consecutive PD patients received bilateral STN DBS surgery in Hualien Tzu-Chi hospital under either desflurane GA (n = 10) or LA (n = 9). We used spike analysis (frequency and modified burst index [MBI]) and the Hilbert transform to obtain signal power measurements for background and spikes, and compared the characterizations of intraoperative microelectrode signals between the two groups. Additionally, STN firing pattern characteristics were determined using a combined approach based on the autocorrelogram and power spectral analysis, which was employed to investigate differences in the oscillatory activities between the groups. Clinical outcomes were assessed using the Unified Parkinson's Disease Rating Scale (UPDRS) before and after surgery. The results revealed burst firing was observed in both groups. The firing frequencies were greater in the LA group and MBI was comparable in both groups. Both the background and spikes were of significantly greater power in the LA group. The power spectra of the autocorrelograms were significantly higher in the GA group between 4 and 8 Hz. Clinical outcomes based on the UPDRS were comparable in both groups before and after DBS surgery. Under controlled light desflurane GA, burst features of the neuronal firing patterns are preserved in the STN, but power is reduced. Enhanced low-frequency (4–8 Hz) oscillations in the MERs for the GA group could be a characteristic signature of desflurane's effect on neurons in the STN.

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Anaesthesia and deep brain stimulation

Cited by 5 publications

References 34 publications

Evaluation of Integrated Pulmonary Index monitoring during sedation for Deep Brain Stimulation

Evaluation of Integrated Pulmonary Index monitoring during sedation for Deep Brain Stimulation

Derin Beyin Stimulatörü Uygulanan Hastalarda Skalp Bloğu ve İnfiltrasyon Anestezisinde Methemoglobinemi Riski

Decreased Power but Preserved Bursting Features of Subthalamic Neuronal Signals in Advanced Parkinson's Patients under Controlled Desflurane Inhalation Anesthesia

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