Anesthetic Challenges in a Parkinson\'s Patient with Deep Brain Stimulation Undergoing Knee Replacement: A Case Report

JOURNAL TITLE: Research & Innovation in Anesthesia

Author
1. Ipsita Choudhary
2. Chandrakant Reddy
3. Manimaran Pushparaj
4. Ankur Gupta
5. Vikas Kulshrestha
6. Arun K Patra
7. Aditya Sapra
ISSN
DOI
10.5005/jp-journals-10049-2037
Volume
8
Issue
2
Publishing Year
2023
Pages
3
  • Article keywords
    Anesthesia management, Deep brain stimulation, Implantable pulse generator, Neurostimulators, Parkinson\'s disease, Partial knee replacement

    Abstract

    Deep brain stimulation (DBS) have progressively emerged as a crucial therapeutic option for those suffering from Parkinson\'s disease (PD), refractory to conventional pharmacological treatments. Although the therapeutic benefits of deep brain stimulation (DBS) have been recognized, the perioperative anesthetic challenges associated with DBS, especially in the setting of unrelated surgical procedures, remain a complex and intricate challenge. In the case under report, a female patient who had undergone DBS implantation was scheduled to undergo a partial knee replacement (PKR) procedure. The administration of anesthesia was complicated by additional challenges, particularly involuntary movements and rigidity, which presented significant challenges for conventional techniques of ventilation and intubation. The situation was made more complex by the possibility of unfavorable interactions occurring between electromedical devices and the DBS system. This case serves as a unique example of the importance of a multidisciplinary approach, where the collaboration of specialists from various fields like anesthesiology, neurophysician, and orthopedic surgeons was vital. The case study provides evidence of the paramount importance of collaborative decision-making, thorough comprehension, and rigorous perioperative planning in the effective management of patients undergoing deep brain stimulation (DBS) procedures.

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