{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:21:56Z","timestamp":1753878116672,"version":"3.41.2"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T00:00:00Z","timestamp":1742774400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Deep brain stimulation has become the standard of care for refractory Parkinson's disease. Neuroimaging advances have led to image\u2010based targeting of the subthalamic nucleus under general anaesthesia (GA), an approach that renders unnecessary microelectrode recording and stimulation tests under local anaesthesia and conscious sedation (CS). We aimed to compare procedures and incidents related to each anaesthetic approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective descriptive comparison of deep brain stimulation under CS versus G. We collected patient and procedure data (e.g., comorbidities, difficult airway criteria, intraoperative monitoring, duration of surgery, hospitalization and motor outcomes) and reviewed intraoperative and postoperative haemodynamic, neurologic and surgery\u2010related incidents.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventy\u2010eight procedures were analysed, 36 in the CS group (47.4%) and 42 in the GA group (52.6%). One\u2010third of the patients were women, and the median age was 62\u2009years (range, 33\u201375). In total, 23 patients experienced at least one perioperative incident, 19 (24.4%) in the CS group and 4 (5.1%) in the GA group (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), even though the GA group included higher\u2010risk patients (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05). Fourteen patients (17.9%) presented disorientation\/agitation, 12 in the CS group (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01). The median duration of the surgery was 5.2\u2009h (range, 3.5\u20139.2\u2009h) in the CS group, split into two sessions, and 4.6\u2009h (range, 4.1\u20135.2\u2009h) in the GA group (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). The median (interquartile range [IQR]) hospital stay was also longer in the CS group, at 7.5\u2009days (IQR 6.75\u201310), compared to 3\u2009days (IQR 3\u20134) in the GA group (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001). Pre\u2010 and postoperative movement disorder evaluations for 38 of the 78 patients (49%) showed significantly improved scores after surgery. No differences were found between the two groups either before (<jats:italic>p<\/jats:italic>\u2009=\u2009.41) or after (<jats:italic>p<\/jats:italic>\u2009=\u2009.52) the surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Deep brain stimulation under GA was associated with fewer perioperative incidents, shorter surgeries and shorter hospital stays.<\/jats:p><\/jats:sec><jats:sec><jats:title>Editorial Comment<\/jats:title><jats:p>Patients with Parkinson's disease who are refractory to standard drug therapy may benefit from the implantation of deep\u2010brain stimulating electrodes. In this report, imaging\u2010guided electrode implantation under general anaesthesia was associated with fewer adverse perioperative events as well as shorter procedure times, compared to implantation guided by intraoperative electrode recording and stimulation under conscious sedation. Since imaging\u2010 and stimulation\u2010guided implantation confers equal long\u2010term benefits to motor function, the results from the current study suggest that general anaesthesia and imaging\u2010guided implantation represent an overall quality improvement for these patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.70017","type":"journal-article","created":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T21:37:57Z","timestamp":1742938677000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Deep brain stimulation under general anaesthesia for Parkinson's disease: A retrospective evaluation of perioperative events and anaesthetic management after switching away from conscious sedation"],"prefix":"10.1111","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2329-8036","authenticated-orcid":false,"given":"Marta","family":"Garcia\u2010Orellana","sequence":"first","affiliation":[{"name":"Neuroanaesthesia Division, Anaesthesiology Department Hospital Clinic de Barcelona, Universitat de Barcelona  Barcelona Spain"},{"name":"Department of Anaesthesiology and Critical Care Kepler University Hospital and Johannes Kepler University  Linz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2633-4717","authenticated-orcid":false,"given":"Felipe","family":"Maldonado","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Perioperative Medicine, Faculty of Medicine, Hospital Cl\u00ednico Universidad de Chile University of Chile  Santiago Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4875-2901","authenticated-orcid":false,"given":"Paola","family":"Hurtado","sequence":"additional","affiliation":[{"name":"Neuroanaesthesia Division, Anaesthesiology Department Hospital Clinic de Barcelona, Universitat de Barcelona  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4757-2893","authenticated-orcid":false,"given":"Gabriel","family":"Pujol\u2010Fontrodona","sequence":"additional","affiliation":[{"name":"Neuroanaesthesia Division, Anaesthesiology Department Hospital Clinic de Barcelona, Universitat de Barcelona  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8653-6038","authenticated-orcid":false,"given":"Pedro","family":"Rold\u00e1n","sequence":"additional","affiliation":[{"name":"Neurosurgery Department Hospital Clinic de Barcelona, Universitat de Barcelona  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7170-0635","authenticated-orcid":false,"given":"Alejandra","family":"Mosteiro","sequence":"additional","affiliation":[{"name":"Neurosurgery Department Hospital Clinic de Barcelona, Universitat de Barcelona  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8755-8124","authenticated-orcid":false,"given":"Jordi","family":"Rumi\u00e0","sequence":"additional","affiliation":[{"name":"Neurosurgery Department Hospital Clinic de Barcelona, Universitat de Barcelona  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1645-538X","authenticated-orcid":false,"given":"Almudena","family":"S\u00e1nchez\u2010G\u00f3mez","sequence":"additional","affiliation":[{"name":"Neurology Department Hospital Clinic de Barcelona, Universitat de Barcelona  Barcelona 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