Vagus nerve stimulation
Anesthesia type

General

Airway

ETT

Lines and access

PIV

Monitors

Standard

Primary anesthetic considerations
Preoperative
Intraoperative

Risk of asystoly/ severe bradycardia due to vagus nerve stimulation. Injury to major vessels in neck can lead to massive hemorrhage

Postoperative
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Vagus nerve stimulator is an adjunctive therapy for refractile epilepsy. It is placed in the left cervical region. The generator/battery is placed in preaxillary area.

Preoperative management

Patient evaluation

System Considerations
Neurologic
Cardiovascular
Pulmonary
Gastrointestinal
Hematologic
Renal
Endocrine
Other

Labs and studies

labs guided by general physical condition of patient

Operating room setup

Patient preparation and premedication

Regional and neuraxial techniques

None. Incisions are small

Intraoperative management

Monitoring and access

Induction and airway management

Positioning

Supine

Maintenance and surgical considerations

Isoflurane and Nitrous Oxide Maintenance preferred for rapid emergence to facilitate early neuro exam.

Patient neuromuscularly blocked throughout to reduce risk of inadvertent injury. No neuromonitoring during procedure.

Emergence

Postoperative management

Disposition

PACU f/b early discharge hoe or as prefeered by primary service

Pain management

Potential complications

Procedure variants

Variant 1 Variant 2
Unique considerations
Position
Surgical time
EBL
Postoperative disposition
Pain management
Potential complications

References