Anesthesia for stereotaxic neurosurgery and deep brain stimulation

Abstract

Deep brain stimulation (DBS) is an effective treatment in patients with neurogenic disorders who have alterations of function such as Parkinson's disease and movement disorders. The insertion of a DBS device is a minimally invasive procedure that includes the placement of electrodes into deep brain structures to obtain microelectrode recordings, macrostimulation for clinical testing of the patient, and connection of the DBS device to an implanted pacemaker. The anesthesiologist plays a key role in the management of patients undergoing this procedure. This chapter reviews current knowledge regarding anesthetic techniques for DBS device insertion and neurostimulator implantation. Various anesthetic issues and possible perioperative complications will be examined. Finally, anesthesia in patients with a neurostimulator implant will be discussed.