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Continuing Education in Anaesthesia, Critical Care & Pain Advance Access originally published online on August 30, 2009
Continuing Education in Anaesthesia, Critical Care & Pain 2009 9(5):157-161; doi:10.1093/bjaceaccp/mkp027
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© The Author [2009]. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournal.org

Anaesthesia and deep brain stimulation

Patrick Dobbs, MBChB FRCA
Consultant Anaesthetist
Sheffield Teaching Hospitals Foundation Trust
C-Floor OPD
Royal Hallamshire Hospital
Glossop Road
Sheffield S10 2JF
UK
Tel: +44 114 2712381
Fax: +44 114 2268736

James Hoyle, MBChB FRCA
Consultant Anaesthetist
Sheffield Teaching Hospitals Foundation Trust
Sheffield
UK

J Rowe, DM FRCS
Consultant Neurosurgeon
Sheffield Teaching Hospitals Foundation Trust
Sheffield
UK
E-mail: patrick.dobbs@sth.nhs.uk (for correspondence)

The first 150 words of the full text of this article appear below.


Key points

Deep brain stimulation is an expanding field for treatment of movement and psychiatric disorders.
The anaesthetist needs to have an understanding of the pathophysiology of the diseases and the pharmacology of existing treatments.
Increasing numbers of patients will present for non-related illnesses with a deep brain stimulator in place.
Multi-disciplinary team involvement is important in planning and management of these patients.
Care is required when using surgical diathermy and in strong magnetic fields.

 

Deep brain stimulators (DBS) are increasingly used to treat chronic conditions, most commonly movement disorders but also pain and psychiatric disturbances. Given the chronic nature of these conditions, while relatively few anaesthetists will have direct experience of the implantation procedures, many more may encounter patients with implanted devices. Importantly, the presence of the DBS devices may have further implications for the investigation and management of these patients, including the use of MRI and the use . . . [Full Text of this Article]


   History
 

   Introduction of DBS
 

   Indications and contra-indications
 
Parkinson's disease

Tremor surgery

Chronic pain

Psychiatric illness


   The DBS surgical procedure
 

   Mode of action
 

   Risks and complications
 
Stimulation side-effects


   Anaesthetic management
 
Emergency removal of the stereotactic frame


   Safety issues
 
General and regional anaesthesia

MRI scanning

Diathermy

External defibrillation

Device programming


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