Anesthesia Strategies and Patient Outcomes in Deep Brain Stimulation Surgery

INTRODUCTION: This study aims to evaluate the anesthesia management strategies employed in deep brain stimulation (DBS) surgery for movement disorders, focusing on patient comfort, surgical conditions, and the effect on electrophysiological monitoring.

METHODS: A retrospective analysis was conducted on the data of 166 patients who underwent DBS surgery for movement disorders at xxx between January 2011 and December 2021. The patients were categorized based on the anesthesia approach used: local anesthesia throughout the procedure, local anesthesia during electrode placement followed by general anesthesia during battery insertion, and general anesthesia for the entire procedure. Data were collected on demographics, comorbidities, anesthesia types, drug usage, surgical procedures, and 30-day postoperative mortality.
RESULTS: The study included 166 patients, with 97 males (58.5%) and 69 females (41.5%). The majority of patients were classified as American Society of Anesthesiologists (ASA) II (86%). The mean surgical duration was 235 minutes. Comorbidities included Parkinson's disease (57.8%), hypertension (18%), and diabetes mellitus (11.4%). DBS was primarily performed for tremor (78.9%). Anesthesia management included sedation with dexmedetomidine, remifentanil, and propofol in patients receiving local anesthesia. General anesthesia involved remifentanil, propofol, and muscle relaxants. No respiratory complications occurred, and all patients were transferred to the service without incident.
DISCUSSION AND CONCLUSION: Anesthesia management in DBS surgery is critical for optimizing patient comfort and maintaining intraoperative electrophysiological integrity. While both local anesthesia and general anesthesia are used, careful monitoring and the choice of appropriate anesthetic agents are essential to minimize complications and ensure the success of the procedure.

Keywords: Anesthesia Management, Deep Brain Stimulation, General Anesthesia, Movement Disorders, Parkinson's Disease, Sedation, Tremor.