%0 Journal Article
%T Sedation and Regional Anesthesia for Deep Brain Stimulation in Parkinson¡¯s Disease
%A Onur Ozlu
%A Sema Sanalbas
%A Dilek Yazicioglu
%A Gulten Utebey
%A Ilkay Baran
%J Journal of Anesthesiology
%D 2014
%R 10.1155/2014/139859
%X Objective. To present the conscious sedation and the regional anesthesia technique, consisting of scalp block and superficial cervical plexus block, used in our institution for patients undergoing deep brain stimulation (DBS) for the treatment of Parkinson¡¯s disease (PD). Methods. The study included 26 consecutive patients. A standardized anesthesia protocol was used and clinical data were collected prospectively. Results. Conscious sedation and regional anesthesia were used in all cases. The dexmedetomidine loading dose was 1£¿¦Ìg£¿kg£¿1 and mean infusion rate was 0.26£¿¦Ìg£¿kg£¿1£¿h£¿1 (0.21) [mean total dexmedetomidine dose: 154.68£¿¦Ìg (64.65)]. Propofol was used to facilitate regional anesthesia. Mean propofol dose was 1.68£¿mg£¿kg (0.84) [mean total propofol dose: 117.72£¿mg (59.11)]. Scalp block and superficial cervical plexus block were used for regional anesthesia. Anesthesia related complications were minor. Postoperative pain was evaluated; mean visual analog scale pain scores were 0 at the postoperative 1st and 6th hours and 4 at the 12th and 24th hours. Values are mean (standard deviation). Conclusions. Dexmedetomidine sedation along with scalp block and SCPB provides good surgical conditions and pain relief and does not interfere with neurophysiologic testing during DBS for PD. During DBS the SCPB may be beneficial for patients with osteoarthritic cervical pain. This trial is registered with Clinical Trials Identifier NCT01789385. 1. Introduction Deep brain stimulation (DBS) is used for the treatment of movement disorders in Parkinson¡¯s disease (PD) [1]. The procedure consists of the application of a stereotactic head frame, determination of target areas, and insertion of electrodes into certain deep brain structures and after neurophysiologic and clinical testing the connection of the electrodes to an implanted pacemaker [1, 2]. Anesthesia is provided mainly by three techniques, local anesthesia, conscious sedation-regional anesthesia, and general anesthesia [1, 2]. A reliable conscious sedation technique should produce a state that the patient is sedated and remains responsive and cooperative to verbal commands and it should not interfere with neurophysiologic testing. The data considering the implications of anesthetics on neurophysiologic testing are inconclusive and intraoperative discomfort is still a problem during DBS [3]. As an institution using conscious sedation and regional anesthesia we aimed to report the anesthesia techniques used in our institution. 2. Methods This study was performed in patients with PD scheduled for DBS. Ethical
%U http://www.hindawi.com/journals/jan/2014/139859/