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J Neurol Surg A Cent Eur Neurosurg 2013; 74(05): 332-334
DOI: 10.1055/s-0033-1342939
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Conversion of Local Anesthesia–Guided Deep Brain Stimulation of the Subthalamic Nucleus to General Anesthesia

Ersoy Kocabicak
1   Department of Neurosurgery, Ondokuz Mayıs University, Samsun, Turkey
,
Dursun Aygun
2   Department of Neurology, Ondokuz Mayıs University, Samsun, Turkey
,
Onur Alptekin
3   Department of Neuromodulation, Medtronic Inc., Istanbul, Turkey
,
Hatice Guz
4   Department of Psychiatry, Ondokuz Mayıs University, Samsun, Turkey
,
Murat Kurt
5   Department of Psychology, Ondokuz Mayıs University, Samsun, Turkey
,
Binnur Sarihasan
6   Department of Anesthesiology, Ondokuz Mayıs University, Samsun, Turkey
,
Yasin Temel
7   Departments of Neurosurgery and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
› Author Affiliations
Further Information

Publication History

24 October 2012

31 December 2012

Publication Date:
01 May 2013 (online)

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Abstract

Background Deep brain stimulation of the subthalamic nucleus (STN) is a widely applied procedure in the treatment of patients with advanced Parkinson disease and is generally performed under local anesthesia. Here we report our experience with the conversion to general anesthesia in two patients with advanced Parkinson disease because of fear reactions intraoperatively.

Case Description Patients received general anesthesia with propofol and were implanted with electrodes at the level of STN guided by multiple-microelectrode electrophysiological recordings after obtaining informed consent. During the recordings the propofol levels were reduced. Postoperative clinical assessments showed marked improvements of motor disability with significant reductions of dopaminergic medication.

Conclusion Our case observations document the possibility of fear reactions intraoperatively and show the possibility of conversion to general anesthesia with a successful outcome.

Keywords

subthalamic nucleus - general anesthesia - propofol - deep brain stimulation - Parkinson disease
 

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