Perioperative Care During Deep Brain Stimulation Surgery

Abstract

Deep brain stimulation (DBS) is a life-changing surgical treatment. More than 150,000 patients worldwide have been treated with DBS, primarily for Parkinson disease and medically refractory tremor and dystonia. However, the use of DBS has recently expanded beyond traditional movement disorders to include the treatment of obsessive compulsive disorder, epilepsy, and other neurological and psychological diseases. Considering this expanded use of DBS, it is essential to understand the role that each member of the multidisciplinary health care team plays and how to avoid possible complications during this procedure. Proper patient selection, precise anatomical placement of the electrode, and proper programming of the implanted device are key aspects of DBS treatment. It also is valuable to understand how the deep brain stimulator is implanted and functions. Accurate lead placement that results in positive outcomes for patients relies on collaboration from an experienced perioperative team led by the neurosurgeon.

Knowledge, Accuracy, Precision: Requirements for the Perioperative Neurosurgical Nurse

“…In “Perioperative care during deep brain stimulation surgery,” Crosley describes the coordination required intraoperatively with the awake patient and team members from anesthesia, neurology, neurosurgery, and imaging. Acquiring a collective team competency requires repetitive use of the knowledge and skills needed to perform these complex procedures.…”

Implementation of a Deep Brain Stimulation Perioperative Pathway for Patients with Medically Refractory Neurological Movement Disorders

“…The patient usually stays in the hospital overnight after stage two. Finally, in stage three, under general anesthesia an implantable pulse generator (IPG) or battery is placed subcutaneously in the subclavicular region and connected to the intracranial electrodes (Crosley, 2018). A month after stage three, the neurologist activates and programs the DBS to provide therapy.…”