title: Influence of propofol and fentanyl on deep brain stimulation of the subthalamic nucleus.
abstract: We investigated the effect of propofol and fentanyl on microelectrode recording (MER) and its clinical applicability during subthalamic nucleus (STN) deep brain stimulation (DBS) surgery. We analyzed 8 patients with Parkinson's disease, underwent bilateral STN DBS with MER. Their left sides were done under awake and then their right sides were done with a continuous infusion of propofol and fentanyl under local anesthesia. The electrode position was evaluated by preoperative MRI and postoperative CT. The clinical outcomes were assessed at six months after surgery. We isolated single unit activities from the left and the right side MERs. There was no significant difference in the mean firing rate between the left side MERs (38.7 ± 16.8 spikes/sec, n=78) and the right side MERs (35.5 ± 17.2 spikes/sec, n=66). The bursting pattern of spikes was more frequently observed in the right STN than in the left STN. All the electrode positions were within the STNs on both sides and the off-time Unified Parkinson's Disease Rating Scale part III scores at six months after surgery decreased by 67% of the preoperative level. In this study, a continuous infusion of propofol and fentanyl did not significantly interfere with the MER signals from the STN. The results of this study suggest that propofol and fentanyl can be used for STN DBS in patients with advanced Parkinson's disease improving the overall experience of the patients.
authors.affiliation: Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Wonki
authors.identifier: 0000-0001-7197-2366
authors.initials: W
authors.lastname: Kim
authors.affiliation: Medical Device Development Center, Osong Medical Innovation Foundation, Cheongwon, Korea.
authors.forename: In Ho
authors.identifier: 0000-0001-6330-3453
authors.initials: IH
authors.lastname: Song
authors.affiliation: Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Yong Hoon
authors.identifier: 0000-0002-0346-2345
authors.initials: YH
authors.lastname: Lim
authors.affiliation: Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Mi-Ryoung
authors.identifier: 0000-0003-0671-2263
authors.initials: MR
authors.lastname: Kim
authors.affiliation: Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Young Eun
authors.identifier: 0000-0002-7182-6569
authors.initials: YE
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Jae Ha
authors.identifier: 0000-0002-6455-3590
authors.initials: JH
authors.lastname: Hwang
authors.affiliation: Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: In Keyoung
authors.identifier: 0000-0002-7761-9456
authors.initials: IK
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Sang Woo
authors.identifier: 0000-0002-5523-3798
authors.initials: SW
authors.lastname: Song
authors.affiliation: Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Jin Wook
authors.identifier: 0000-0002-3773-3940
authors.initials: JW
authors.lastname: Kim
authors.affiliation: Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Woong-Woo
authors.identifier: 0000-0002-8767-7967
authors.initials: WW
authors.lastname: Lee
authors.affiliation: Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Han-Joon
authors.identifier: 0000-0001-8219-9663
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Medical Imaging Laboratory and CyberMed, Inc., Seoul, Korea.
authors.forename: Cheolyoung
authors.identifier: 0000-0001-5586-9342
authors.initials: C
authors.lastname: Kim
authors.affiliation: Department of Medical Engineering, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Hee Chan
authors.identifier: 0000-0002-2112-426X
authors.initials: HC
authors.lastname: Kim
authors.affiliation: Department of Biomedical Engineering, Hanyang University, Seoul, Korea.
authors.forename: In Young
authors.identifier: 0000-0001-9580-7074
authors.initials: IY
authors.lastname: Kim
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Hee Pyoung
authors.identifier: 0000-0002-4772-0780
authors.initials: HP
authors.lastname: Park
authors.affiliation: Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Dong Gyu
authors.identifier: 0000-0002-5740-6189
authors.initials: DG
authors.lastname: Kim
authors.affiliation: Department of Neurology, Seoul National University College of Medicine, Seoul, Korea. ; Ischemic/Hypoxic Disease Institute, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Beom Seok
authors.identifier: 0000-0003-2491-3544
authors.initials: BS
authors.lastname: Jeon
authors.affiliation: Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea. ; Ischemic/Hypoxic Disease Institute, Seoul National University College of Medicine, Seoul, Korea. ; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea. ; Clinical Research Institute, Seoul National University Hospital, Seoul, Korea.
authors.forename: Sun Ha
authors.identifier: 0000-0003-3007-8653
authors.initials: SH
authors.lastname: Paek
mesh_terms: D000368:Aged; D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D046690:Deep Brain Stimulation; D004567:Electrodes, Implanted; D005260:Female; D005283:Fentanyl / Q000494:pharmacology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008839:Microelectrodes; D008875:Middle Aged; D010300:Parkinson Disease / Q000517:prevention & control*; D015742:Propofol / Q000494:pharmacology*; D012720:Severity of Illness Index; D020531:Subthalamic Nucleus / Q000187:drug effects* / Q000502:physiology; D014057:Tomography, X-Ray Computed
chemical_list: D018686:Anesthetics, Intravenous; D005283:Fentanyl; D015742:Propofol
keywords: Deep Brain Stimulation; Fentanyl; Microelectrodes; Parkinson Disease; Propofol; Subthalamic Nucleus