Deep brain stimulator

[Intrathecal]

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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?

 

[Planktonmd]

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?

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.

 

[aphistis]

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.

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. 😛

 

[Trisomy13]

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. 😛

That would be one hell of a poster presentation at the ASA meeting.

 

[Intrathecal]

My concern was that the cautery could cause the stimulator to fire and may cause seizure.

 

[huktonfonix]

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.

 

[lobelsteve]

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.

 

[dfk]

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.

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