Zech, Nina and Seemann, Milena and Seyfried, Timo F. and Lange, Max and Schlaier, Juergen and Hansen, Ernil (2018) Deep Brain Stimulation Surgery without Sedation. STEREOTACTIC AND FUNCTIONAL NEUROSURGERY, 96 (6). pp. 370-378. ISSN 1011-6125, 1423-0372
Full text not available from this repository. (Request a copy)Abstract
Background: Sedatives and opioids used during deep brain stimulation (DBS) surgery interfere with optimal target localization and add to side effects and risks, and thus should be minimized. Objective: To retrospectively test the actual need for sedatives and opioids when cranial nerve blocks and specific therapeutic communication are applied. Methods: In a case series, 64 consecutive patients treated with a strong rapport, constant contact, non-verbal communication and hypnotic suggestions, such as dissociation to a "safe place," reframing of disturbing noises and self-confirmation, were compared to 22 preceding patients under standard general anaesthesia or conscious sedation. Results: With introduction of the protocol the need for sedation dropped from 100% in the control group to 5%, and from a mean dose of 444 mg to 40 mg in 3 patients. Remifentanil originally used in 100% of the patients in an average dose of 813 mu g was reduced in the study group to 104 mu g in 31% of patients. There were no haemodynamic reactions indicative of stress during incision, trepanation, electrode insertion and closure. Conclusion: With adequate therapeutic communication, patients do not require sedation and no or only low-dose opioid treatment during DBS surgery, leaving patients fully awake and competent during surgery and testing. (C) 2018 S. Karger AG, Basel
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | PARKINSONS-DISEASE; ANESTHESIA; INFILTRATION; NEUROSURGERY; CRANIOTOMY; MANAGEMENT; Deep brain stimulation; Sedation; Opioids; Target localization |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Abteilung für Psychosomatische Medizin Medicine > Lehrstuhl für Neurochirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 20 Mar 2020 06:08 |
| Last Modified: | 20 Mar 2020 06:08 |
| URI: | https://pred.uni-regensburg.de/id/eprint/15237 |
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