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Deep brain stimulator

Discussion in 'Anesthesiology' started by Intrathecal, Jan 5, 2009.

  1. Intrathecal

    Intrathecal ASA Member
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    Have a patient coming in for EGD/Colonoscopy. He has a deep brain stimulator for Parkinson's Dz/Depression. Possible use of cautery for polypectomy. Asked by GI guy whether stimulator needs to be turned off. I am thinking that we don't need to. What's the right answer?
     
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  3. Planktonmd

    Moderator Emeritus Lifetime Donor Classifieds Approved 10+ Year Member

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    Ask yourself this question: Why are we concerned about cautery in a patient with a pacemaker or AICD?
    The answer should be: We don't want the device to misfire or stop working because this can cause some serious badness.
    Now what if a brain stimulator misfires or stops working???
    The answer: No big deal the worst case would be that the patient would get his symptoms back until you reprogram the device.
    I wouldn't worry about it.
     
  4. aphistis

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    I dunno. You'd hate for the patient to wake up fluent in Klingon and on a 63-hour circadian rhythm. You might have to reprogram more than just the DBS. :p
     
  5. Trisomy13

    Trisomy13 ultra
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    That would be one hell of a poster presentation at the ASA meeting.
     
  6. Intrathecal

    Intrathecal ASA Member
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    My concern was that the cautery could cause the stimulator to fire and may cause seizure.
     
  7. huktonfonix

    huktonfonix board certified!
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    its highly unlikely. Im pretty sure the cautery they use is bipolar. Even if its not unless youre slapping the grounding pad on his head, the current has got a loooong way to go to reach the stim.
     
  8. lobelsteve

    lobelsteve SDN Lifetime Donor
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    Agreed. Bipolar has been used extensively with SCS (same technology) without much issue. There are a few cases of cautery arcing and cooking the cord, but I believe these were not bipolar cautery units.
     
  9. dfk

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    in order to answer this, wouldn't we have to know where the polyp is and where the generator was placed? ex: esophagus and chest wall
     

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