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Review
. 2023 Oct 1;36(5):461-467.
doi: 10.1097/ACO.0000000000001296. Epub 2023 Jul 26.

Management strategies for patients with neurologic stimulators during nonneurologic surgery: an update and review

Jacqueline M Morano  1 , Jamie L Uejima  1 , Avery Tung  2 , Joshua M Rosenow  1
Affiliations
Review

Management strategies for patients with neurologic stimulators during nonneurologic surgery: an update and review

Jacqueline M Morano et al. Curr Opin Anaesthesiol. .

Abstract

Purpose of review: The goal of this review is to summarize the perioperative management of noncardiac implanted electrical devices (NCIEDs) and update the anesthesiologist on current recommendations for management when a NCIED is encountered during a nonneurosurgical procedure.

Recent findings: Indications for NCIEDs continue to expand, and increasing numbers of patients with NCIEDs are presenting for nonneurosurgical procedures. Recent case reports demonstrate that NCIEDs may meaningfully affect perioperative management including use of electrocautery and neuromonitoring. This review highlights the importance of evaluating NCIED function (including lead impedance) prior to surgery, provides an update on the MRI compatibility and safety of these devices, and reviews the management of patients with altered respiratory drive because of vagal nerve stimulators.

Summary: As the prevalence of NCIEDs in patients presenting for surgery increases, anesthesiologists will likely encounter these devices more frequently. To provide a well tolerated anesthetic, anesthesiologists should recognize the concerns associated with NCIEDs and how best to address them perioperatively.

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References

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