Anesthetic Considerations and Perioperative Management of Sacral Neuromodulators: Literature Review and Initial Recommendations

Abd‐Elsayed, Alaa; Mitry, Christopher; Mitry, Jonathan; Nadherny, Weston

doi:10.1111/ner.13168

Cited by 2 publications

(10 citation statements)

References 16 publications

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“…Additionally, measures should be taken to systematically address any physiological compromise that may have occurred with temporary cessation of neurostimulation since turning the device off is generally recommended. Such measures include careful management of bowel and bladder care in patients who required their SNS systems to be turned off for up to several hours 11…”

Section: General Perioperative Considerationsmentioning

confidence: 99%

“…For surgeries that occurred in the vicinity of the neuromodulation device, a physical exam to ensure that all the components are appropriately maintained is necessary 10 11 65. Additionally, postoperative imaging can rule out lead migration and compromise to the device components (ie, brain imaging following intracranial surgeries in patients with a DBS) 80 81.…”

Section: General Perioperative Considerationsmentioning

confidence: 99%

“…When in doubt, DBS systems should remain turned off if there is a concern, until the appropriate clearance is obtained by the movement disorder clinical care team. On the contrary, neuraxial and peripheral neuromodulation systems may safely be interrogated and turned back on after a review of the postoperative exam and imaging 10 11 65…”

Section: General Perioperative Considerationsmentioning

confidence: 99%

“…Postoperative pain should be addressed similarly in patients with and without neuromodulation devices and should incorporate the use of multimodal analgesia, both pharmacological and non-pharmacological. In those patients with devices for treating chronic pain conditions, such as SCS, DRGS, or PNS, modifying stimulation parameters is unlikely to be successful in managing acute pain 10 11 65. After the aforementioned clearance following postoperative physical exam and imaging, patients may be cleared to reprogram their neurostimulation device with their personal remote programmers, which can use various stimulation programs and intensities to control their chronic pain.…”

Section: General Perioperative Considerationsmentioning

confidence: 99%

“…Each of these systems has differing mechanisms of actions and indications, and thus, there are unique considerations for the perioperative management of patients with these devices 10 11…”

Section: Introductionmentioning

confidence: 99%

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Perioperative and anesthetic considerations for the management of neuromodulation systems

Orhurhu

Hussain

Karri

et al. 2023

Reg Anesth Pain Med

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The use of neuromodulation systems is increasing for the treatment of various pathologies ranging from movement disorders to urinary incontinence to chronic pain syndromes. While the type of neuromodulation devices varies, they are largely categorized as intracranial (eg, deep brain stimulation), neuraxial (eg, spinal cord stimulation, dorsal root ganglion stimulation, and intrathecal drug delivery systems), or peripheral (eg, sacral nerve stimulation and peripheral nerve stimulation) systems. Given the increasing prevalence of these systems in the overall population, it is important for anesthesiologists, surgeons, and the perioperative healthcare team to familiarize themselves with these systems and their unique perioperative considerations. In this review, we explore and highlight the various neuromodulation systems, their general perioperative considerations, and notable special circumstances for perioperative management.

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Section: General Perioperative Considerationsmentioning

confidence: 99%

Section: General Perioperative Considerationsmentioning

confidence: 99%

Section: General Perioperative Considerationsmentioning

confidence: 99%

Section: General Perioperative Considerationsmentioning

confidence: 99%

“…Each of these systems has differing mechanisms of actions and indications, and thus, there are unique considerations for the perioperative management of patients with these devices 10 11…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Perioperative and anesthetic considerations for the management of neuromodulation systems

Orhurhu

Hussain

Karri

et al. 2023

Reg Anesth Pain Med

Self Cite

View full text Add to dashboard Cite

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Anesthesia management in patients with neurostimulators

Rathore

Dinsmore

Venkatraghavan

2023

International Anesthesiology Clinics

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Neurostimulators are active implantable devices that clinicians use to perform diverse neuromodulation treatments in patients with neurological and non-neurological disorders. 1 Neuromodulation works on the principle of reverse engineering the disorder allowing the clinicians to think from a patient-system point of view. This enables them to personalize interventions by understanding the patient-specific pathophysiology that can translate insights from cognitive neuroscience into targeted therapies for various disorders. 2 Neurostimulators can be intracranial [deep brain stimulation (DBS)], neuraxial [spinal cord stimulation (SCS), sacral nerve stimulators], or peripheral (vagal nerve trigeminal nerve or other peripheral nerve stimulation). The number of patients using neurostimulators is growing rapidly, making it imperative for anesthesiologists to understand these devices and their potential interactions with other medical equipment. 3 The literature on perioperative management of patients with neurostimulators is scarce, and most of the information comes from case reports and manufacturer recommendations. In this review, we provide an overview of various neurostimulators, general considerations, and recommendations regarding the perioperative management of these patients for specific surgeries.

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Anesthetic Considerations and Perioperative Management of Sacral Neuromodulators: Literature Review and Initial Recommendations

Cited by 2 publications

References 16 publications

Perioperative and anesthetic considerations for the management of neuromodulation systems

Perioperative and anesthetic considerations for the management of neuromodulation systems

Anesthesia management in patients with neurostimulators

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