Case 33 - Airwaycrisis during deep brain stimulator placement

Summary

Deep brain stimulation (DBS) is the ultimate therapy for motor disease disorders like Parkinson's disease (PD) and dystonia. This chapter presents a case study of a 70-year-old male with a past medical history of hypertension, hyperlipidemia, obstructive sleep apnea, and PD. The patient was scheduled for unilateral DBS electrode insertion in the subthalamic nucleus under sedation. The DBS procedure requires fixation of the patient's head to the stereotactic apparatus for accurate electrode placement. Patient selection and preparation for the procedure are very important in order to minimize the perioperative complications. Propofol can induce respiratory depression and airway obstruction, as was seen in the case. Placement of a laryngeal mask airway (LMA) is the ideal method for managing the upper airway in emergency situations during DBS procedures. Dexmedetomidine creates an environment in which the patient feels comfortable and relaxed during the procedure.