Anaesthetic management of patients undergoing deep brain simulation: A retrospective review of 8 cases from a tertiary care center of Pakistan

Abstract

Objectives: To review anaesthesia related outcome, perioperative complications and overall length of stay (LOS) in hospital for patients who had deep brain stimulation (DBS).
 Methods: The study was retrospective review of patients medical records diagnosed with Parkinson disease (PD) and underwent DBS at The Aga Khan University Hospital, Karachi from 2017-2019. Data was reviewed from file notes and patient chart and recorded on predesigned Performa. Frequency and percentages were used to present the data.
 Results: All patients were anaesthetized using Sleep-Awake-Sleep technique (SAS). Dexmedetomidine was mainly used for conscious sedation. Bispectral index monitor (BIS) was used to monitor the depth of sedation, and kept between 70-85 during sedative phase. All patients had successful intraoperative neurological monitoring, stimulation, and placement of electrodes. Total duration of anesthesia varied significantly in between the patients. Maximum duration was 600 minutes. None of our patient had any intraoperative event related to anaesthetic management. Overall five patients had some adverse events during ward stay. Mean LOS in hospital was four days.
 Conclusion: Anaesthetic management of DBS is well-tolerated. It requires dedicated team. The SAS technique is excellent for intraoperative neurophysiological monitoring. Careful selection of sedative agents and monitoring depth of anaesthesia using BIS would be beneficial in terms of improving related outcomes.
 doi: https://doi.org/10.12669/pjms.36.7.2870
 How to cite this:Ahmed U, Shafiq F, Kumar D, Ahsan K, Ghaffar W, Bari E. Anaesthetic management of patients undergoing deep brain simulation: A retrospective review of 8 cases from a tertiary care center of Pakistan. Pak J Med Sci. 2020;36(7):---------. doi: https://doi.org/10.12669/pjms.36.7.2870
 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Associations of the timing of sleep and meals with the presence of gastroesophageal reflux disease in community‐dwelling women in Japan

“…To our knowledge, so far, nine cross-sectional or case-control studies have examined some of associations between GERD and skipping breakfast, having nighttime snacks or dinner-to-bedtime intervals. [22][23][24][25][26][27][28][29][30] Some but not all studies observed significant associations. There have been no studies on the timing of sleep or meals and GERD, even using clock time.…”

“…To our knowledge, so far, nine cross‐sectional or case–control studies have examined some of associations between GERD and skipping breakfast, having night‐time snacks or dinner‐to‐bedtime intervals 22‐30 . Some but not all studies observed significant associations.…”