Perioperative Events During Deep Brain Stimulation: The Experience at Cleveland Clinic

Deep brain stimulation (DBS) of the basal ganglia is an evolving technique for managing intractable movement disorders such as those due to Parkinson disease. We conducted a retrospective review of the DBS procedures that have been performed at our institution to determine the frequency and types complications that occurred.After Institutional Review Board approval, 258 procedures involving 250 patients were retrospectively reviewed. Univariate analysis using the chi test for the categorical variables and a t-test for the continuous variables was performed on patients with and without complications to determine potential risk factors.The most common anesthesia technique used for DBS procedures was monitored anesthesia care using a propofol infusion during the early part of the case. Airway, respiratory, neurologic, and psychologic/psychiatric complications occurred. Age was found to be an independent risk factor for complications during DBS.This retrospective study demonstrates that age is an independent risk factor for complications during DBS procedures. Monitored anesthesia care using propofol seems to be a safe technique for DBS procedures; however, dexmedetomidine can also be used.