title: Bilateral Deep Brain Stimulation of the Subthalamic Nucleus under Sedation with Propofol and Fentanyl.
abstract: Awakening during deep brain stimulation (DBS) surgery may be stressful to patients. The aim of the current study was to evaluate the effect on MER signals and their applicability to subthalmic nucleus (STN) DBS surgery for patients with Parkinson's disease (PD) under sedation with propofol and fentanyl. Sixteen consecutive patients with PD underwent STN-DBS surgery with propofol and fentanyl. Their MER signals were achieved during the surgery. To identify the microelectrodes positions, the preoperative MRI and postoperative CT were used. Clinical profiles were also collected at the baseline and at 6 months after surgery. All the signals were slightly attenuated and contained only bursting patterns, compared with our previous report. All electrodes were mostly located in the middle one third part of the STN on both sides of the brain in the fused images. Six months later, the patients were improved significantly in the medication-off state and they met with less dyskinesia and less off-duration. Our study revealed that the sedation with propofol and fentanyl was applicable to STN-DBS surgery. There were no significant problems in precise positioning of bilateral electrodes. The surgery also improved significantly clinical outcomes in 6-month follow-up.
authors.affiliation: Department of Neurology, Eulji General Hospital, Seoul, Republic of Korea.
authors.forename: Woong-Woo
authors.initials: WW
authors.lastname: Lee
authors.affiliation: Department of Neurology, Myongji Hospital, Gyeonggi, Republic of Korea.
authors.forename: Gwanhee
authors.initials: G
authors.lastname: Ehm
authors.affiliation: Department of Neurology, Ulsan University Hospital, Ulsan, Republic of Korea.
authors.forename: Hui-Jun
authors.initials: HJ
authors.lastname: Yang
authors.affiliation: Medical Device Development Center, Osong Medical Innovation Foundation, Chungcheong, Republic of Korea.
authors.forename: In Ho
authors.initials: IH
authors.lastname: Song
authors.affiliation: Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Yong Hoon
authors.initials: YH
authors.lastname: Lim
authors.affiliation: Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Mi-Ryoung
authors.initials: MR
authors.lastname: Kim
authors.affiliation: Department of Neurology, Hallym University Sacred Heart Hospital, Gyeonggi, Republic of Korea.
authors.forename: Young Eun
authors.initials: YE
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Daejeon Woori Hospital, Gyeonggi, Republic of Korea.
authors.forename: Jae Ha
authors.initials: JH
authors.lastname: Hwang
authors.affiliation: Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Hye Ran
authors.initials: HR
authors.lastname: Park
authors.affiliation: Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Jae Min
authors.initials: JM
authors.lastname: Lee
authors.affiliation: Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Jin Wook
authors.initials: JW
authors.lastname: Kim
authors.affiliation: Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Han-Joon
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Medical Imaging Laboratory, CyberMed Inc., Seoul, Republic of Korea.
authors.forename: Cheolyoung
authors.initials: C
authors.lastname: Kim
authors.affiliation: Department of Medical Engineering, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Hee Chan
authors.initials: HC
authors.lastname: Kim
authors.affiliation: Department of Biomedical Engineering, Han Yang University, Seoul, Republic of Korea.
authors.forename: Eunkyoung
authors.initials: E
authors.lastname: Park
authors.affiliation: Department of Biomedical Engineering, Han Yang University, Seoul, Republic of Korea.
authors.forename: In Young
authors.initials: IY
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea.|Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Dong Gyu
authors.initials: DG
authors.lastname: Kim
authors.affiliation: Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea.|Department of Neurology, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Beomseok
authors.initials: B
authors.lastname: Jeon
authors.affiliation: Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea.|Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Sun Ha
authors.initials: SH
authors.lastname: Paek
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D018686:Anesthetics, Intravenous / Q000627:therapeutic use; D046690:Deep Brain Stimulation; D004567:Electrodes, Implanted; D005260:Female; D005283:Fentanyl / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008839:Microelectrodes; D008875:Middle Aged; D010300:Parkinson Disease / Q000473:pathology* / Q000601:surgery; D015742:Propofol / Q000627:therapeutic use; D012720:Severity of Illness Index; D020531:Subthalamic Nucleus / Q000502:physiology*; D014057:Tomography, X-Ray Computed
chemical_list: D018686:Anesthetics, Intravenous; D005283:Fentanyl; D015742:Propofol