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DBS Surgery with General Anesthesia Safe, Effective

J Neurosurg; 2018 Aug; Chen, Mirzadeh, Chapple, et al

Deep brain stimulation (DBS) performed with the patient under general anesthesia (GA) to treat essential tremor (ET) is as safe and effective as traditional DBS surgery with intraoperative test stimulation while the patient is under conscious sedation without GA, according to a recent study. Clinical outcomes were prospectively collected at baseline and 3-month follow-up for patients undergoing DBS surgery performed by a single surgeon. Stereotactic, euclidean, and radial errors of lead placement were calculated. Functional (activities of daily living), quality of life (Quality of Life in Essential Tremor [QUEST] questionnaire), and tremor severity outcomes were compared between groups. Researchers found:

  • 56 patients underwent surgery: 16 without GA (24 electrodes) and 40 with GA (66 electrodes).
  • The mean baseline functional scores and QUEST summary indices were not different between groups.
  • Non-GA and GA groups did not differ significantly regarding mean postoperative percentages of functional improvement (non-GA, 47.9% vs GA, 48.1%) or QUEST summary indices (non-GA, 79.9% vs GA, 74.8%).
  • Accuracy was comparable between groups (mean radial error 0.9 ± 0.3 mm for non-GA and 0.9 ± 0.4 mm for GA patients).

Citation:

Chen T, Mirzadeh Z, Chapple KM, et al. Intraoperative test stimulation versus stereotactic accuracy as a surgical end point: A comparison of essential tremor outcomes after ventral intermediate nucleus deep brain stimulation. J Neurosurg. 2018;129(12):290-298. doi:10.3171/2017.3.JNS162487.

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