Difference between revisions of "Deep brain stimulation lead placement"
(Created page with "{{Infobox surgical procedure | anesthesia_type = General or awake | airway = ETT or natural airway if awake | lines_access = 1-2 PIV | monitors = Standard, 5-lead EKG | considerations_preoperative = | considerations_intraoperative = If under MRI guidance, will need MRI-safe equipment. Keep very still for MRI images | considerations_postoperative = }} Subthalamic nucleus deep brain stimulation (DBS) lead placement is a neurosurgical procedure whereby leads for DBS are...") |
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Induce general anesthesia with ETT if MRI guidance will be used. | Induce general anesthesia with ETT if MRI guidance will be used. | ||
If awake, patient should be kept calm and told to hold as still as possible. Consider dexmedetomidine bolus | If awake, patient should be kept calm and told to hold as still as possible. Consider dexmedetomidine bolus. | ||
===Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. -->=== | ===Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. -->=== | ||
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If lead placement is guided by MRI, must use MRI-compatible monitors and machine. Consider hefty doses of NDMBs to maintain maximum stillness for better image quality. | If lead placement is guided by MRI, must use MRI-compatible monitors and machine. Consider hefty doses of NDMBs to maintain maximum stillness for better image quality. | ||
If awake, consider dexmedetomidine infusion to assist. Goal is to keep patient still but not disinhibited. | If awake, consider dexmedetomidine infusion to assist. Goal is to keep patient still but not disinhibited. May also consider remifentanil and/or propofol gtts. to alter level of sedation relatively quickly. | ||
===Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. -->=== | ===Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. -->=== | ||
Latest revision as of 14:45, 15 March 2026
| Anesthesia type |
General or awake |
|---|---|
| Airway |
ETT or natural airway if awake |
| Lines and access |
1-2 PIV |
| Monitors |
Standard, 5-lead EKG |
| Primary anesthetic considerations | |
| Preoperative | |
| Intraoperative |
If under MRI guidance, will need MRI-safe equipment. Keep very still for MRI images |
| Postoperative | |
| Article quality | |
| Editor rating | |
| User likes | 0 |
Subthalamic nucleus deep brain stimulation (DBS) lead placement is a neurosurgical procedure whereby leads for DBS are placed in the subthalamic nucleus to help control the tremors of Parkinson disease.
Overview
Indications
Parkinson disease
Surgical procedure
Preoperative management
Patient evaluation
| System | Considerations |
|---|---|
| Airway | |
| Neurologic | |
| Cardiovascular | |
| Pulmonary | |
| Gastrointestinal | |
| Hematologic | |
| Renal | |
| Endocrine | |
| Other |
Labs and studies
Operating room setup
Patient preparation and premedication
Regional and neuraxial techniques
Intraoperative management
Monitoring and access
- Standard ASA monitors
- 1-2 IVs
Induction and airway management
Induce general anesthesia with ETT if MRI guidance will be used.
If awake, patient should be kept calm and told to hold as still as possible. Consider dexmedetomidine bolus.
Positioning
Supine, typically head 90 or 180 deg away
Maintenance and surgical considerations
If lead placement is guided by MRI, must use MRI-compatible monitors and machine. Consider hefty doses of NDMBs to maintain maximum stillness for better image quality.
If awake, consider dexmedetomidine infusion to assist. Goal is to keep patient still but not disinhibited. May also consider remifentanil and/or propofol gtts. to alter level of sedation relatively quickly.
Emergence
Postoperative management
Disposition
Pain management
Potential complications
Procedure variants
| Variant 1 | Variant 2 | |
|---|---|---|
| Unique considerations | ||
| Indications | ||
| Position | ||
| Surgical time | ||
| EBL | ||
| Postoperative disposition | ||
| Pain management | ||
| Potential complications |
References
Top contributors: Tony Wang and Sean Pecoraro