![]() For dorsal column and DRG stimulation, monitored anesthesia care, where patients are awake but very relaxed, or general anesthesia with neuromonitoring during the operation (so that surgeons can check the function of the nerves in real time) is recommended. Generally, starting antibiotics before the surgery and then stopping the antibiotics within 24 h after the surgery is recommended. We searched various online databases to find papers that discussed anesthetic management around these surgeries. We review management for different forms of neuromodulation including dorsal column stimulators (DCSs), dorsal root ganglion (DRG) stimulators, peripheral nerve stimulators and intrathecal pumps. This paper reviews current literature and provides guidelines based on our single center experience to discuss anesthetic management of patients before surgery, during surgery and after the surgery. The implantation of neuromodulation devices requires surgery. Neuromodulation is a procedure wherein the nerves that are responsible for pain are stimulated, for example with electrical pulses, to reduce the pain signals originating from that nerve. More research is necessary to articulate specific pre-operative, intra-operative and postoperative management guidelines and recommendations for dorsal column stimulator, DRG stimulation, PNS and intrathecal pump implantation.Īnesthetic management dorsal column stimulation dorsal root ganglion stimulation intrathecal drug delivery neuromodulation peripheral nerve stimulation. There is little information on appropriate anesthetic management during these forms of neuromodulation. For dorsal column and DRG stimulation, monitored anesthesia care or general anesthesia with intra-operative neuromonitoring is recommended for peripheral nerve stimulation and intrathecal pump implementation, monitored anesthesia care is preferred. Generally, pre-operative antibiotics are recommended with discontinuation within 24 h postoperatively. This paper performs a review of current literature as well as uses our single-center experience to discuss pre-operative, intra-operative and, briefly, postoperative management for dorsal column stimulators (DCSs), dorsal root ganglion (DRG) stimulators, peripheral nerve stimulators (PNSs) and intrathecal pumps.
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