Journal of the Korean Society of Stereotactic and Functional Neurosurgery 2011;7(1):84-87.
Published online June 30, 2011.
General Endotracheal Anesthesia for Parkinsonism-DBS Surgery
Jae Won Jeong, Moo Seong Kim, Seong Tae Kim, Kun Soo Lee, Sung Hwa Paeng, Se Young Pyo, Young Gyun Jeong, Yong Tae Jung, Sang Jin Kim, Yang Weon Kim
Department of Neurosurgery, Neurology, Emergency Medicine, Inje University, Busan Paik Hospital, Busan, Korea
Surgical treatment of Parkinson's disease and other movement disorders have been performed using local anesthesia. However, increasing experience and technology and expanding indications are driving small but increasing the need to perform surgery under general anesthesia. Material and Methods: Preoperative evaluation, peri- and intraoperative approaches are considered. Patients may not tolerated being awake for a lengthy procedure in stages of advanced age, mild dementia, pain, adverse health conditions, severe torsion dystonia or choreoathetosis which may result in increased risk of pulling out of the frame. We operated on 10 patients under general endotracheal anesthesia. We assessed the effect of the anesthetic agent via microelectrode recording. Result: Some anesthetic agents i.e. propofol, sevoflurorane showed good spikes. However, anesthetic agents operated utilized during desflurane anesthesia showed reduced spikes.
Subthalamic stimulation is the most effective treatments for Parkinson patients suffering from levodopa-induced motor complications. DBS surgery performed under general anesthesia with sevoflurorane is another option for patients experiencing severe anxiety, or panic reactions.
Key Words: Parkinsonism, Surgery, General, Panic.
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