Influence of general anesthesia in intraoperative electrophysiology and postoperative efficacy of subthalamic nucleus deep brain stimulation in Parkinson's disease
10.3760/cma.j.issn.1671-8925.2018.07.007
- VernacularTitle:全麻对帕金森病丘脑底核脑深部电刺激术术中电生理及术后疗效的影响
- Author:
Zixiao YIN
1
,
2
;
Guohui LU
;
Yunyun LUO
;
Yuanlu HUANG
;
Suyue ZHENG
;
Yaqing YU
;
Jian DUAN
;
Dongwei ZHOU
;
Tao HONG
Author Information
1. 330006 南昌,南昌大学第一附属医院神经外科
2. 330006 南昌,南昌大学第一临床医学院
- Keywords:
Parkinson's disease;
Deep brain stimulation;
Microelectrode recording;
General anesthesia;
Sevoflurane
- From:
Chinese Journal of Neuromedicine
2018;17(7):685-691
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the influence of general anesthesia (GA) on bilateral subthalamic nucleus deep brain stimulation (STN-DBS) in treating Parkinson's disease (PD) through microelectrode recording (MER),and discuss the differences between different modes of anesthesia.Methods A retrospective analysis was performed on clinical data of 31 PD patients accepted bilateral STN-DBS in our hospital from June 2015 to June 2017.Nine patients accepted surgery under GA (A group):4 patients were treated with intravenous anesthesia (A1 group),and 5 patients were treated with inhalation anesthesia (A2 group);22 patients accepted surgery under local anesthesia LA group.MER indexes,including STN discharge frequency,STN recorded length,and maximum target error,and short-term (6 months) efficacy were recorded.A linear regression analysis was performed to find possible influence factors on discharge frequency and improving rate of UPDRS scores.Results The discharge frequencies of B group,A1 group and A2 group were 51.42 Hz±6.28 Hz,35.79 Hz±7.02 Hz and 43.18 Hz±5.87 Hz,respectively,with significant differences (F=12.181,P=0.000);as compared with that in the B group,the discharge frequencies of A1 group and A2 group were significantly lower (P＜0.05).The STN recorded lengths of B group,A1 group and A2 group were 5.48 mm±0.33 mm,5.06 mm±0.15 mm and 5.22 mam±0.16 mm,respectively,with significant differences (F=4.115,P=0.027);as compared with that in the B group,the recorded lengths of A1 group and A2 group were significantly shorter (P＜0.05).A1 group had the maximum target error,but no significant differences were noted among the 3 groups (P＞ 0.05).Six months after the surgery,the UPDRS-Ⅲ scores and Schwab-England scores of A group and B group were decreased and daily levodopa equivalent (LEDD) was decreased.As compared with B group,A group had significantly better improvement in Hoehn & Yahr grading (P＜0.05).Disease durations were positively correlated with discharge frequency (r=0.539,P=0.002);age and improving rate of UPDRS scores were negatively correlated (r=-0.572,P=-0.001);preoperative LEDD and improving rate of UPDRS scores were positively correlated (r=0.725,P=-0.000).Conclusions Bilateral STN-DBS performed under GA in PD enjoys good efficacy,which shows no obvious difference as compared with that under LA.Inhalation anesthesia had less influence on electrophysiology than intravenous anesthesia.
