Microelectrode assisted deep brain stimulation: Considerations for anesthesia

Deep Brain Stimulation Pub Date : 2023-12-22 DOI:10.1016/j.jdbs.2023.12.006

Marcus L.F. Janssen , Michaël J. Bos

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Abstract

Deep brain stimulation (DBS) is a widely accepted and safe treatment for selected patients with movement disorders. Many medical centres prefer to perform DBS lead positioning using local anesthesia to enable microelectrode recordings (MER) and assess the therapeutic and side effects of stimulation. These steps allow for the precise identification of the borders and subdomains of the target nuclei using the electrophysiological properties. Additionally, they facilitate the evaluation of the therapeutic window and thereby improve the accuracy of final DBS lead placement. However, in some patients awake surgery can be challenging and, as a result, sedation or general anesthesia may be needed. Unfortunately, if not used properly this approach can lead to alterations in the electrophysiological signature and interfere with clinical testing, potentially affecting surgical outcomes. Consequently, the type and dose of anesthesia needs to be chosen carefully.

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微电极辅助脑深部刺激：麻醉注意事项

深部脑刺激（DBS）是一种被广泛接受的安全治疗方法，适用于选定的运动障碍患者。许多医疗中心倾向于使用局部麻醉进行 DBS 导联定位，以便进行微电极记录 (MER)，并评估刺激的治疗效果和副作用。通过这些步骤，可以利用电生理特性精确确定靶核的边界和亚域。此外，这些步骤还有助于评估治疗窗口，从而提高最终 DBS 导联放置的准确性。然而，对某些患者来说，清醒手术可能具有挑战性，因此可能需要镇静或全身麻醉。遗憾的是，如果使用不当，这种方法可能会导致电生理特征的改变并干扰临床测试，从而可能影响手术效果。因此，需要谨慎选择麻醉的类型和剂量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Deep Brain Stimulation

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