Interleaved Propofol-Ketamine Maintains DBS Physiology and Hemodynamic Stability: A Double-Blind Randomized Controlled Trial.
Movement disorders : official journal of the Movement Disorder Society April 1, 2024 Evgeniya Kornilov, Halen Baker Erdman, Eilat Kahana et al. 11 citations
For deep brain stimulation (DBS) surgery, an anesthesia regimen combining low-dose ketamine infusion with propofol sedation provided high-quality microelectrode recordings comparable to the standard awake approach. In a randomized trial of 30 Parkinson's patients undergoing subthalamic DBS, those receiving 0.25 mg/kg/h ketamine during physiological testing had similar electrophysiological signatures and lead localization as those receiving saline. Tremor amplitude was slightly lower under ketamine. Patients in the ketamine group reported significantly higher satisfaction with anesthesia. Motor improvement, measured by the Unified Parkinson's Disease Rating Scale part III, was similar between groups. No negative effects on hemodynamic stability or cognition were observed. Ketamine-induced conscious sedation appears to offer superior patient satisfaction and hemodynamic stability while maintaining comparable surgical outcomes.