Deep brain stimulation under general anaesthesia for Parkinson's disease: A retrospective evaluation of perioperative events and anaesthetic management after switching away from conscious sedation

Abstract

Background: Deep brain stimulation has become the standard of care for refractory Parkinson's disease. Neuroimaging advances have led to image-based targeting of the subthalamic nucleus under general anaesthesia (GA), an approach that renders unnecessary microelectrode recording and stimulation tests under local anaesthesia and conscious sedation (CS). We aimed to compare procedures and incidents related to each anaesthetic approach. Methods: Retrospective descriptive comparison of deep brain stimulation under CS versus G. We collected patient and procedure data (e.g., comorbidities, difficult airway criteria, intraoperative monitoring, duration of surgery, hospitalization and motor outcomes) and reviewed intraoperative and postoperative haemodynamic, neurologic and surgery-related incidents. Results: Seventy-eight procedures were analysed, 36 in the CS group (47.4%) and 42 in the GA group (52.6%). One-third of the patients were women, and the median age was 62 years (range, 33–75). In total, 23 patients experienced at least one perioperative incident, 19 (24.4%) in the CS group and 4 (5.1%) in the GA group (p