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脑深部电刺激术中的围手术期事件:克利夫兰诊所的经验

Perioperative events during deep brain stimulation: the experience at cleveland clinic.

作者信息

Khatib Reem, Ebrahim Zeyd, Rezai Ali, Cata Juan P, Boulis Nicolas M, John Doyle D, Schurigyn Tamara, Farag Ehab

机构信息

Department of General Anesthesiology, Cleveland Clinic, Cleveland, Ohio 44195, USA.

出版信息

J Neurosurg Anesthesiol. 2008 Jan;20(1):36-40. doi: 10.1097/ANA.0b013e318157a15a.

Abstract

BACKGROUND

Deep brain stimulation (DBS) of the basal ganglia is an evolving technique for managing intractable movement disorders such as those due to Parkinson disease. We conducted a retrospective review of the DBS procedures that have been performed at our institution to determine the frequency and types complications that occurred.

METHODS

After Institutional Review Board approval, 258 procedures involving 250 patients were retrospectively reviewed. Univariate analysis using the chi test for the categorical variables and a t-test for the continuous variables was performed on patients with and without complications to determine potential risk factors.

RESULTS

The most common anesthesia technique used for DBS procedures was monitored anesthesia care using a propofol infusion during the early part of the case. Airway, respiratory, neurologic, and psychologic/psychiatric complications occurred. Age was found to be an independent risk factor for complications during DBS.

CONCLUSION

This retrospective study demonstrates that age is an independent risk factor for complications during DBS procedures. Monitored anesthesia care using propofol seems to be a safe technique for DBS procedures; however, dexmedetomidine can also be used.

摘要

背景

基底神经节的深部脑刺激(DBS)是一种用于治疗诸如帕金森病所致难治性运动障碍的不断发展的技术。我们对在我们机构进行的DBS手术进行了回顾性研究,以确定发生并发症的频率和类型。

方法

经机构审查委员会批准后,对涉及250例患者的258例手术进行了回顾性研究。对有并发症和无并发症的患者进行分类变量的卡方检验和连续变量的t检验的单因素分析,以确定潜在的危险因素。

结果

DBS手术最常用的麻醉技术是在手术早期使用丙泊酚输注的监测麻醉管理。发生了气道、呼吸、神经和心理/精神并发症。年龄被发现是DBS手术期间并发症的独立危险因素。

结论

这项回顾性研究表明,年龄是DBS手术期间并发症的独立危险因素。使用丙泊酚的监测麻醉管理似乎是DBS手术的一种安全技术;然而,右美托咪定也可使用。

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