Deep brain stimulation lead placement
Anesthesia type |
General or awake |
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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 |
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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.
Emergence
Postoperative management
Disposition
Pain management
Potential complications
Procedure variants
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Indications | ||
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EBL | ||
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References
Top contributors: Tony Wang