Percutaneous Spinal Cord Stimulation Lead Placement Under Deep Sedation and General Anesthesia

Area of Science:

• Pain Management
• Neurosurgery
• Anesthesiology

Background:

• Spinal cord stimulation (SCS) is a key therapy for neuropathic pain.
• Current guidelines recommend awake SCS lead placement for patient feedback.
• Physician adherence to these guidelines is not well-documented.

Purpose of the Study:

• To survey physician practices regarding anesthesia use during SCS lead placement.
• To determine the frequency of deep sedation and general anesthesia in SCS procedures.

Main Methods:

• A survey was distributed to members of the American Society of Regional Anesthesia and Pain Medicine (ASRA) and the Spine Intervention Society (SIS).
• Respondents reported on their use of deep sedation and general anesthesia for SCS placement.
• Data on reported complications were also collected.

Main Results:

• A significant percentage of physicians utilize deep sedation (77%) and general anesthesia (45%) for SCS implants.
• Complications related to general anesthesia during SCS placement were rarely reported (94% never experienced one).

Conclusions:

• Deep sedation and general anesthesia are commonly used for SCS lead placement by many physicians.
• This practice contrasts with current recommendations for awake procedures.
• Further research is needed to reconcile clinical practices with safety guidelines.