Anesthetic Considerations for Deep Brain Stimulation

The anesthetic method was determined mainly according to the patients' preferences. Whereas, patients who were incapable of enduring awake DBS, including those with extreme anxiety, reduced cooperation, severe convulsions and difficult breathing, were operated under GA. We also showed reasons for the patients who were operated under GA in Supplementary Table 1. According to the anesthetic method applied, patients were assigned to LA group and GA group. In LA group, patients received local scalp anesthesia with 0.5% ropivacaine and kept conscious without sedation during MER and electrode implantation. In GA group, patients were administered a bolus of 2 mg/kg BW propofol and 1 mg/kg BW remifentanil for induction. Then, anesthesia was maintained at 2 mg/kg BW propofol and 1 mg/kg BW remifentanil by a target-controlled infusion (TCI) system. Bispectral index (BIS) was applied to monitor the depth of anesthesia. The infusion of anesthetics was adjusted before MER and BIS was maintained at 40–60 to ensure the recognition of STN signals.