title: Intraoperative Hypotension During Second Stage of Deep Brain Stimulator Placement: Same Day versus Different Day Procedures.
abstract: BACKGROUND
  We evaluated blood pressure management associated with implantable pulse generator (IPG) procedure on same day (SD) versus different day (DD) from deep brain stimulation (DBS) placement.
  
  
  METHODS
  A retrospective chart review of 99 records for vasopressors given during IPG using a negative binomial regression model was performed. An association between SD versus DD, cumulative vasopressor dose, and minimum and maximum mean arterial pressure (MAP) were sought.
  
  
  RESULTS
  No significant association between SD versus DD DBS and the number of times vasopressors were given during stage II, estimated ratio of means (CI) of 1.8 (0.9-3.5); P = 0.07. Day of stage II had no association with the cumulative dose of vasopressor given during stage II, with an estimated difference in means (CI) of 2.4 (-0.4 to 5.3). The SD group had a significantly lower mean of minimum stage II MAP compared with DD, with an estimated difference in means (CI) of -10.5 (-17.4 to -3.5; P < 0.001). There was no association with maximum stage II MAP, with an estimated difference in means (CI) of -2.8 (-17.6 to 12.0; P = 0.63).
  
  
  CONCLUSIONS
  No difference in intraoperative vasopressor use was found between SD versus DD IPG placement, but the SD group had a significantly lower minimum MAP.
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, University of Massachusetts, Worcester, Massachusetts, USA.
authors.forename: Eman M
authors.initials: EM
authors.lastname: Nada
authors.affiliation: Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Shobana
authors.initials: S
authors.lastname: Rajan
authors.affiliation: Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Radhika
authors.initials: R
authors.lastname: Grandhe
authors.affiliation: Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Milind
authors.initials: M
authors.lastname: Deogaonkar
authors.affiliation: Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Zimmerman
authors.affiliation: Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Zeyd
authors.initials: Z
authors.lastname: Ebrahim
authors.affiliation: Cleveland Clinic, Cleveland, Ohio, USA. Electronic address: avitsir@ccf.org.
authors.forename: Rafi
authors.initials: R
authors.lastname: Avitsian
mesh_terms: D000368:Aged; D062186:Arterial Pressure; D046690:Deep Brain Stimulation; D005260:Female; D006801:Humans; D007022:Hypotension / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D007431:Intraoperative Complications / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D010300:Parkinson Disease / Q000628:therapy*; D019919:Prosthesis Implantation / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
chemical_list: D014662:Vasoconstrictor Agents
keywords: Anesthesia; Deep brain stimulation; Hypotension; Parkinson disease