Perioperative events during deep brain stimulation: The experience at Cleveland Clinic

Background: 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. Methods: After Institutional Review Board approval, 258 procedures involving 250 patients were retrospectively reviewed. Univariate analysis using the chi(2) 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. Results: 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. Conclusion: 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.