title: Conversion of local anesthesia-guided deep brain stimulation of the subthalamic nucleus to general anesthesia.
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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  Our case observations document the possibility of fear reactions intraoperatively and show the possibility of conversion to general anesthesia with a successful outcome.
authors: Department of Neurosurgery, Ondokuz Mayıs University, Samsun, Turkey. ersoykocabicak@gmail.com
authors: Ersoy
authors: E
authors: Kocabicak
authors: Dursun
authors: D
authors: Aygun
authors: Onur
authors: O
authors: Alptekin
authors: Hatice
authors: H
authors: Guz
authors: Murat
authors: M
authors: Kurt
authors: Binnur
authors: B
authors: Sarihasan
authors: Yasin
authors: Y
authors: Temel
mesh_terms: D000328:Adult; D000768:Anesthesia, General; D000772:Anesthesia, Local; D000978:Antiparkinson Agents / Q000008:administration & dosage / Q000627:therapeutic use; D046690:Deep Brain Stimulation / Q000379:methods*; D004567:Electrodes, Implanted; D005239:Fear / Q000523:psychology; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000523:psychology / Q000628:therapy*; D007980:Levodopa / Q000008:administration & dosage / Q000627:therapeutic use; D008839:Microelectrodes; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D010300:Parkinson Disease / Q000601:surgery / Q000628:therapy; D013238:Stereotaxic Techniques; D020531:Subthalamic Nucleus / Q000502:physiology*; D016896:Treatment Outcome
chemical_list: D000978:Antiparkinson Agents; D007980:Levodopa