Anesthetic considerations for Deep Brain Stimulation (DBS) surgery: A Review

Abstract

Background: Deep Brain Stimulation (DBS) has been accepted as one of the treatment modalities for movement disorders, including Parkinson’s disease. DBS is a minimally invasive procedure that takes several steps, including the brain mapping for the target lesions, microelectrode recordings, placement of the stimulator electrodes, intraoperative clinical testing, and the implantation of the programmable pulse generator. The anesthetic technique varies from general anesthesia, local anesthesia, and intravenous sedation. The anesthetic concerns include the interference of anesthetic drugs to microelectrode recording, and an awake and cooperative patient. The anesthesia providers should recognize the complications that may develop during the surgery, which include patients’ loss of airway control, seizures, and intracerebral hemorrhage (ICH). This review will focus on the perioperative management for Parkinsonian patients who will be the candidates of the DBS surgery; summarize choice of anesthetic technique, maintenance of anesthesia, and how to manage when complications develop.