General anaesthesia for deep brain stimulator electrode insertion in XXXX .

@entity1 @entity191
BACKGROUND: This paper compares the use of general and local anaesthetic in @entity1 having deep brain stimulator (DBS) surgery. It is a retrospective case note study of 46 @entity1 treated consecutively with subthalamic nucleus stimulation for @entity191 as practise changed in a Neurosurgical unit. METHODS: The first 20 @entity1 (LA group) had permanent electrodes placed under local anaesthesia. The remaining 26 @entity1 (GA group) had the entire procedure under general anaesthesia. The groups were similar for age, sex, duration of @entity191 and preoperative levodopa requirement. RESULTS: The clinical results were similar in that within each group, the reduction in levodopa was not only clinically but also statistically significant (p   <   0.001 for both, paired t test): for the LA group, the 6-month requirement was 39.4% (29.5-52.6%) of the preoperative requirement and for the GA group, the 6-month requirement was 32.3% (25.2-41.5%) of the preoperative requirement. The reduction in levodopa was maintained at 1  year. Of note, duration of surgery and length of stay were reduced. The mean duration of surgery was 8.2  h (7.8-8.6) for the LA group and 7.5  h (7.2-7.8) for the GA group (p   =   0.003). The geometric mean of length of hospital stay was 5.4  days(4.6-6.3) for the LA group and 3.8  days (3.4-4.4) for the GA group (p   =   0.001) There was no difference in electrophysiological recording. CONCLUSION: This study describes benefits in the GA group for the entire procedure of STN DBS. In these samples, there was no difference in the adverse effects seen in @entity1 undergoing deep brain stimulator insertion with general anaesthetic compared with local anaesthetic. The use of general anaesthetic did not detract from the known benefits of surgery.
