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Although it offers high\u2010quality microelectrode recordings and therapeutic\u2010window assessment, it potentially causes patients extreme stress and might result in suboptimal surgical outcomes. General anesthesia or deep sedation is an alternative, but may reduce physiological testing reliability and lead localization accuracy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The aim is to investigate a novel anesthesia regimen of ketamine\u2010induced conscious sedation for the physiological testing phase of DBS surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Parkinson's patients undergoing subthalamic DBS surgery were randomly divided into experimental and control groups. During physiological testing, the groups received 0.25\u2009mg\/kg\/h ketamine infusion and normal saline, respectively. Both groups had moderate propofol sedation before and after physiological testing. The primary outcome was recording quality. Secondary outcomes included hemodynamic stability, lead accuracy, motor and cognitive outcome, patient satisfaction, and adverse events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty patients, 15 from each group, were included. Intraoperatively, the electrophysiological signature and lead localization were similar under ketamine and saline. Tremor amplitude was slightly lower under ketamine. Postoperatively, patients in the ketamine group reported significantly higher satisfaction with anesthesia. The improvement in Unified Parkinson's disease rating scale part\u2010III was similar between the groups. No negative effects of ketamine on hemodynamic stability or cognition were reported perioperatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Ketamine\u2010induced conscious sedation provided high quality microelectrode recordings comparable with awake conditions. Additionally, it seems to allow superior patient satisfaction and hemodynamic stability, while maintaining similar post\u2010operative outcomes. Therefore, it holds promise as a novel alternative anesthetic regimen for DBS. \u00a9 2024 The Authors. <jats:italic>Movement Disorders<\/jats:italic> published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mds.29746","type":"journal-article","created":{"date-parts":[[2024,2,24]],"date-time":"2024-02-24T00:30:09Z","timestamp":1708734609000},"page":"694-705","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Interleaved Propofol\u2010Ketamine Maintains <scp>DBS<\/scp> Physiology and Hemodynamic Stability: A Double\u2010Blind <scp>Randomized Controlled Trial<\/scp>"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2234-6558","authenticated-orcid":false,"given":"Evgeniya","family":"Kornilov","sequence":"first","affiliation":[{"name":"Department of Anesthesiology Rabin Medical Center, Beilinson 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