Akademik Veri Yönetim Sistemi
Anestezi Dergisi, cilt.20, sa.2, ss.86-91, 2012 (Scopus)
Objective: The aim of this study was to evaluate and report our experience of the anesthetic management for deep brain stimulation in the treatment of Parkinson's disease. Methods: After the ethics committee's approval all patients undergoing deep brain stimulation for the treatment of Parkinson's disease between 2009-2011 were included in the study. Associated data were obtained from patient files and anesthesia records. Results: Mean age of seventeen patients (eight female/nine male) undergoing deep brain stimulation was 56.7±7.8 years. All surgical procedures were peformed under local anesthetic infiltration. In the first stage (placement of the stereotactic head-frame and imaging studies) and second stage (placement of the deep brain stimulator electrodes) of the procedure were performed under conscious sedation and analgesia. Sedation scores were evaluated with the Modified Observer Assessment of Alertness/Sedation score (OAA/S) and 1 mg of midazolam and 25 mcg of fentanyl were given in repeated doses to achieve the score of 4. During the first and second stages of the procedure, 4.41±1.0 mg midazolam was used. No fentanyl was used in the first stage and 45.4±2.6 mcg of fentanyl was used for eleven patients during the second stage. The patients received general anesthesia in the third part of the procedure which is for connection of the stimulator electrodes to the pulse generator. Tenoxicam and tramadol were used for postoperative analgesia. No complications were observed. Conclusion: Patient's comfort and safety may be improved when conscious sedation are used during the deep brain stimulation procedure which was being performed only under local anesthesia in the past. Continuous observation of the patient's sedation level and proper anesthetics are essential to avoid disturbing effects of anesthetic techniques on the quality of the procedure.