Anaesthetic management and perioperative complications during deep brain stimulation surgery: Our institutional experience

Abstract

Background: Deep brain stimulation (DBS) surgery is an established therapeutic option for alleviating movement disorders. It represents unique challenges for anaesthesiologists. We retrospectively reviewed the patients, who underwent this surgery at our institution, to study anaesthetic management and perioperative complications. Materials and Methods: After taking approval from the Institutional Ethics Committee, medical, surgical and anaesthesia records of 67 patients who were admitted to undergo DBS surgery during 11 years period (January 2001 to December 2011) were retrieved and reviewed. Sixty-five patients underwent the procedure. Various anaesthetic events and perioperative complications were noted and appropriate statistical analysis was carried out to analyse the data. Results: Electrode placement under monitored anaesthesia care (MAC) was the most commonly used technique (86% of patients). Intra-operative complications occurred in 16 patients (24%) whereas post-operative complication occurred in 10 patients (15.4%). There was one mortality. Though age >60 years and American Society of Anesthesiologists status >II were found to be the risk factors for post-operative complications in the bivariate analysis; they were not significant in multivariate analysis. Conclusions: We report our experience of DBS surgery, which was performed using MAC in majority of patients, though general anaesthesia is also feasible. Further prospective randomised studies comprising large number of patients are warranted to corroborate our finding and to find out the most suitable sedative agent.

Keywords

• anaesthesia
• awake craniotomy
• complications
• deep brain stimulation surgery
• movement disorders
• parkinsonism