title: Anesthesia for deep brain stimulation.
abstract: OBJECTIVE
  Deep brain stimulation (DBS) is a well accepted treatment modality for many movement disorders such as Parkinson's disease and an increasing number of other functional neurological disorders like dystonias and epilepsy. This review will highlight the recent developments in our knowledge regarding the effects of anesthetic agents on neurophysiologic recording and anesthetic management of patients undergoing the insertion of a DBS.
  
  
  RESULTS
  There are new indications for DBS as well as new therapeutic target nuclei that are being examined. Better surgical technique and new imaging techniques like frameless stereotaxy are likely to improve patient tolerance of these procedures. The effects of anesthetic drugs on nuclei microelectrode recording and the need for an awake and cooperative patient for intraoperative macrostimulation testing continue to be the challenge for the anesthesiologist. Intracranial hemorrhage, seizures, and venous air embolism are the important perioperative complications needing urgent care. There are reports of increased incidence of postoperative behavioral and cognitive problems after DBS insertion.
  
  
  CONCLUSIONS
  There will continue to be an increase in the use of DBS for many neurological and functional disorders, especially in the aging baby boomer population. Anesthetic technique will vary depending on the prevalent practice in individual institutions and requirements of the specific surgical procedure.
authors.affiliation: Department of Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada. Lashmi.Venkatraghavan@uhn.on.ca
authors.forename: Lashmi
authors.initials: L
authors.lastname: Venkatraghavan
authors.forename: Pirjo
authors.initials: P
authors.lastname: Manninen
mesh_terms: D000758:Anesthesia / Q000009:adverse effects; D000777:Anesthetics / Q000009:adverse effects; D001921:Brain / Q000033:anatomy & histology / Q000473:pathology; D046690:Deep Brain Stimulation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008991:Monitoring, Physiologic; D019635:Neurosurgical Procedures; D010300:Parkinson Disease / Q000628:therapy
chemical_list: D000777:Anesthetics