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Sedatives and Hypnotics Drugs: Miscellaneous Agents01:17

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Intra-Operative Behavioral Tasks in Awake Humans Undergoing Deep Brain Stimulation Surgery
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Deep Brain Stimulation Surgery without Sedation.

Nina Zech1,2, Milena Seemann2, Timo F Seyfried2

  • 1Center for Deep Brain Stimulation, University Hospital Regensburg, Regensburg, Germany.

Stereotactic and Functional Neurosurgery
|December 6, 2018
PubMed
Summary
This summary is machine-generated.

Minimizing sedatives and opioids during deep brain stimulation (DBS) surgery is crucial. Therapeutic communication and nerve blocks enable awake DBS surgery, reducing the need for anesthesia and improving patient outcomes.

Keywords:
Deep brain stimulationOpioidsSedationTarget localization

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Area of Science:

  • Neurosurgery
  • Anesthesiology
  • Psychology

Background:

  • Sedatives and opioids used in deep brain stimulation (DBS) surgery can hinder accurate target localization and increase risks.
  • Minimizing intraoperative medication is essential for patient safety and surgical precision.

Purpose of the Study:

  • To evaluate the necessity of sedatives and opioids during DBS surgery when employing cranial nerve blocks and therapeutic communication techniques.
  • To determine if these non-pharmacological methods can replace or reduce the need for traditional anesthesia.

Main Methods:

  • A retrospective case series comparing 64 patients who received therapeutic communication and nerve blocks with 22 patients under general anesthesia or conscious sedation.
  • The communication protocol included rapport building, constant contact, non-verbal cues, and hypnotic suggestions for dissociation and reframing.

Main Results:

  • Sedation requirements decreased from 100% in the control group to 5% in the intervention group.
  • Opioid (remifentanil) use was significantly reduced, with 31% of patients in the intervention group requiring only 104 µg compared to 813 µg in the control group.
  • No significant hemodynamic stress responses were observed during critical surgical stages in the intervention group.

Conclusions:

  • Adequate therapeutic communication and nerve blocks allow patients to remain awake and competent during DBS surgery.
  • This approach effectively eliminates or significantly reduces the need for sedation and opioids, enhancing surgical safety and patient experience.