Awake Deep Brain Stimulator Cases: A Fine Line Between Adequate Sedation And Airway Emergency
A 67-year-old male with a history of COPD and bilateral essential tremors refractory to medical management presented for Stage 1 of 2 Deep Brain Stimulator placement. Given the need for macrostimulation, plan was made for sedation with propofol infusion and fentanyl pushes prn. During final closure, the patient experienced airway obstruction from oversedation with subsequent desaturation. This required prompt incision closure and frame removal in order to properly mask ventilate the patient -- resulting in improvement in O2 saturations and resumption of spontaneous ventilation. We discuss the anesthetic and airway management strategies for awake DBS cases to mitigate respiratory complications.
Al-Attar N, Asbahi M. Awake deep brain stimulator cases: a fine line between adequate sedation and airway emergency. Presented at: American Society of Anesthesiology Annual Meeting; 2022 Oct 21-25; New Orleans, LA.