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Side effects of vagus nerve stimulation therapy include: cough; voice changes; vocal cord adduction; rarely, obstructive sleep apnoea; and arrhythmia. Patients with implanted vagus nerve stimulation devices may present for unrelated surgery and critical care to clinicians who are unfamiliar with their function and safe management. These guidelines have been formulated by multidisciplinary consensus based on case reports, case series and expert opinion to support clinicians in the management of patients with these devices. The aim is to provide specific guidance on the management of vagus nerve stimulation devices in the following scenarios: the peri\u2010operative period; peripartum period; during critical illness; and in the MRI suite. Patients should be aware of the importance of carrying their personal vagus nerve stimulation device magnet with them at all times to facilitate urgent device deactivation if necessary. We advise that it is generally safer to formally deactivate vagus nerve stimulation devices before general and spinal anaesthesia. During periods of critical illness associated with haemodynamic instability, we also advise cessation of vagus nerve stimulation and early consultation with neurology services.<\/jats:p>","DOI":"10.1111\/anae.16012","type":"journal-article","created":{"date-parts":[[2023,4,25]],"date-time":"2023-04-25T04:03:13Z","timestamp":1682395393000},"page":"747-757","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Management of vagus nerve stimulation therapy in the peri\u2010operative period"],"prefix":"10.1111","volume":"78","author":[{"given":"L.","family":"Broderick","sequence":"first","affiliation":[{"name":"Beaumont Hospital  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Tuohy","sequence":"additional","affiliation":[{"name":"Rotunda Hospital  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Solymos","sequence":"additional","affiliation":[{"name":"St Vincent's University Hospital  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Lakhani","sequence":"additional","affiliation":[{"name":"The Walton Centre NHS Foundation Trust  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Staunton","sequence":"additional","affiliation":[{"name":"Beaumont Hospital  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Ennis","sequence":"additional","affiliation":[{"name":"Beaumont Hospital  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Clark","sequence":"additional","affiliation":[{"name":"Bristol Children's Hospital  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I. 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