• Wonki Kim, In Ho Song, Yong Hoon Lim, Mi-Ryoung Kim, Young Eun Kim, Jae Ha Hwang, In Keyoung Kim, Sang Woo Song, Jin Wook Kim, Woong-Woo Lee, Han-Joon Kim, Cheolyoung Kim, Hee Chan Kim, In Young Kim, Hee Pyoung Park, Dong Gyu Kim, Beom Seok Jeon, and Sun Ha Paek.
• Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.
• J. Korean Med. Sci. 2014 Sep 1; 29 (9): 1278-86.

AbstractWe investigated the effect of propofol and fentanyl on microelectrode recording (MER) and its clinical applicability during subthalamic nucleus (STN) deep brain stimulation (DBS) surgery. We analyzed 8 patients with Parkinson's disease, underwent bilateral STN DBS with MER. Their left sides were done under awake and then their right sides were done with a continuous infusion of propofol and fentanyl under local anesthesia. The electrode position was evaluated by preoperative MRI and postoperative CT. The clinical outcomes were assessed at six months after surgery. We isolated single unit activities from the left and the right side MERs. There was no significant difference in the mean firing rate between the left side MERs (38.7 ± 16.8 spikes/sec, n=78) and the right side MERs (35.5 ± 17.2 spikes/sec, n=66). The bursting pattern of spikes was more frequently observed in the right STN than in the left STN. All the electrode positions were within the STNs on both sides and the off-time Unified Parkinson's Disease Rating Scale part III scores at six months after surgery decreased by 67% of the preoperative level. In this study, a continuous infusion of propofol and fentanyl did not significantly interfere with the MER signals from the STN. The results of this study suggest that propofol and fentanyl can be used for STN DBS in patients with advanced Parkinson's disease improving the overall experience of the patients.

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