Anaesthesia for Deep Brain Stimulation Surgery

Abstract

Deep brain stimulation (DBS) has become a widely accepted surgical treatment for patients with medical intractable movement disorders such as Parkinson's disease, essential tremor and dystonia, neuronal diseases or disorders such as epilepsy and psychiatric diseases such as obsessive-compulsive disorder. The procedure can be carried out using different anaesthesia strategies; however, most centres have developed local anaesthetic protocols considering the neurosurgeon's needs and individual preferences. Currently, none of the anaesthetic techniques for DBS surgery has proven to be superior to others. Perioperative challenges and demands for the anaesthesiologist depend on the specific neurologic and psychiatric disorder. The anaesthetic goals are to provide optimal surgical conditions and patient comfort and facilitate target localization. In addition, the anaesthesiologist needs to be aware of perioperative complications and how to act under these circumstances. This chapter gives a structured, up-to-date overview of the anaesthetic management of patients who undergo DBS insertion.