2015, Raz et al. 2010). MERs help guide the placement of electrodes, so their accuracy is critical for the success of procedures and interference may occur with intravenous anesthetics, such as propofol (Raz et al. 2010). In addition to MERs, macrostimulation testing is very important. Since the goal of DBS is to treat the symptoms of Parkinson’s, it is helpful to see intraoperatively if stimulation of the targeted brain region alters the characteristic tremors, rigidity, and bradykinesia of PD. Some medications can interfere with these symptoms, thus interfering with macrostimulation testing. For example, remifentanil is known to cause rigidity (Hogue et al. 1996). In a recent retrospective study, Lange et al. found that length of surgery was significantly increased (ps. The authors noted that placing the pulse generator and drilling the burr holes under general anesthesia reduced patient anxiety due to lack of awareness of the drilling process. The second stage in this reversed model includes microelectrode recording and macrostimulation testing under local anesthesia (Van Horne et al. 2015). Further investigation of this technique could show promise in the future of DBS staging and anesthetic
2015, Raz et al. 2010). MERs help guide the placement of electrodes, so their accuracy is critical for the success of procedures and interference may occur with intravenous anesthetics, such as propofol (Raz et al. 2010). In addition to MERs, macrostimulation testing is very important. Since the goal of DBS is to treat the symptoms of Parkinson’s, it is helpful to see intraoperatively if stimulation of the targeted brain region alters the characteristic tremors, rigidity, and bradykinesia of PD. Some medications can interfere with these symptoms, thus interfering with macrostimulation testing. For example, remifentanil is known to cause rigidity (Hogue et al. 1996). In a recent retrospective study, Lange et al. found that length of surgery was significantly increased (ps. The authors noted that placing the pulse generator and drilling the burr holes under general anesthesia reduced patient anxiety due to lack of awareness of the drilling process. The second stage in this reversed model includes microelectrode recording and macrostimulation testing under local anesthesia (Van Horne et al. 2015). Further investigation of this technique could show promise in the future of DBS staging and anesthetic