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Friday, July 13, 2012

DEEP BRAIN STIMULATION; ANAESTHETIC CONCERNS

#Check for difficult airway / history s/o OSAS; in that case we may have to modify our plans of sedation in the initial part of the procedure
#Associated psychosis- Paient may not cooperate well for assessment / procedure.
#Check the max duration for which dyskinesia is effectively suppressed by syndopa and dose it appropriately in the perioperative days
#Check for h/o aspiration, nasal regurgitation in the past.
#Ensure availability of nasal prongs for oxygen administration
#Overiew: At the time of insertion of electrodes, we can use sedation using dexmedetomidine in addition to scalp block and local infiltration.We can stop sedation before the start of neurological assessment. Further proceedings are done while the patient is fully awake. The battery placement is done under GA.
#Give appropriate antibiotic prophylaxis