Occipital nerve stimulator placement under general anesthesia

Initial experience with 5 cases and review of the literature

Terrence L. Trentman, Richard S. Zimmerman, David William Dodick, Carla L. Dormer, Bert B. Vargas

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Anesthesiologists support nerve stimulator insertion procedures, including occipital nerve stimulator placement for refractory headache disorders. Sedation during these cases can be challenging on account of variable surgical stimuli and surgery positioning that contribute to neck flexion, potentially compromising the airway. Greater patient comfort and safety may be found in performing permanent occipital stimulator placement procedures entirely under general anesthesia, assuming that appropriate stimulation patterns can be achieved in patients who are unable to provide intraoperative feedback. The purpose of this study is to describe our initial experience with occipital nerve stimulator placement performed entirely under general anesthesia and the resulting stimulation patterns, and to review the medical literature regarding the anesthetic techniques used during these novel neurosurgical procedures. After institutional review board approval, we reviewed the records of 5 patients who underwent permanent occipital nerve stimulator placement under general anesthesia. Appropriateness of the postoperative stimulation patterns was noted in addition to complications. The medical literature was searched for occipital stimulation surgery studies that also described the anesthetic technique. We found that all 5 patients underwent uncomplicated general anesthetics. Postoperative occipital stimulation was nonpainful and symmetrical for all. The literature search provided little information on the anesthetic technique; most procedures were performed at least in part under local anesthesia with sedation. On the basis of this small case series, we conclude that the occipital nerve stimulator systems can be successfully placed under general anesthesia while still achieving the desired occipital region stimulation. Further studies are needed to correlate occipital nerve stimulator placement under general anesthesia and long-term headache control.

Original languageEnglish (US)
Pages (from-to)158-162
Number of pages5
JournalJournal of Neurosurgical Anesthesiology
Volume22
Issue number2
DOIs
StatePublished - Apr 2010

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General Anesthesia
Anesthetics
Neurosurgical Procedures
Occipital Lobe
General Anesthetics
Headache Disorders
Research Ethics Committees
Local Anesthesia
Patient Safety
Headache
Neck

Keywords

  • General anesthesia
  • Headache
  • Peripheral nerve stimulation

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Clinical Neurology
  • Surgery

Cite this

Occipital nerve stimulator placement under general anesthesia : Initial experience with 5 cases and review of the literature. / Trentman, Terrence L.; Zimmerman, Richard S.; Dodick, David William; Dormer, Carla L.; Vargas, Bert B.

In: Journal of Neurosurgical Anesthesiology, Vol. 22, No. 2, 04.2010, p. 158-162.

Research output: Contribution to journalArticle

Trentman, Terrence L. ; Zimmerman, Richard S. ; Dodick, David William ; Dormer, Carla L. ; Vargas, Bert B. / Occipital nerve stimulator placement under general anesthesia : Initial experience with 5 cases and review of the literature. In: Journal of Neurosurgical Anesthesiology. 2010 ; Vol. 22, No. 2. pp. 158-162.
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