Venous Air Embolism during Deep Brain Stimulation Surgery in an Awake Supine PatientDeogaonkar A. · Avitsian R. · Henderson J.M. · Schubert A.
aDivision of Anesthesiology and Critical Care Medicine, Departments of bGeneral Anesthesiology and cNeurosurgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA
Deep brain stimulation (DBS) of the subthalamic nucleus and globus pallidus is used to improve Parkinsonian symptoms and reduce levodopa-induced motor complications in Parkinson’s disease (PD). This procedure is usually performed with minimal or no sedation to allow accurate feedback from patients during surgery. Venous air embolism (VAE) has been previously reported in patients undergoing awake neurosurgical procedures for brain tumors or pallidotomy for PD. We describe a case of intraoperative VAE in an awake, supine patient while undergoing DBS surgery for PD who presented with coughing, tachypnea and hypoxemia. The difference in clinical presentation between VAE in awake vs. anesthetized patients is discussed as are intraoperative monitoring techniques and management options.
Armin Schubert, MD, MBA
Chairman, Department of General Anesthesiology, E-31
The Cleveland Clinic Foundation, 9500 Euclid Avenue
Cleveland, OH 44195 (USA)
Tel. +1 216 444 3754, Fax +1 216 444 9628, E-Mail firstname.lastname@example.org
Published online: April 8, 2005
Number of Print Pages : 4
Number of Figures : 1, Number of Tables : 3, Number of References : 14
Stereotactic and Functional Neurosurgery
Vol. 83, No. 1, Year 2005 (Cover Date: Released May 2005)
Journal Editor: Roberts, D.W. (Lebanon, N.H.)
ISSN: 1011–6125 (print), 1423–0372 (Online)
For additional information: http://www.karger.com/sfn