• Curr Opin Anaesthesiol · Oct 2023

    Review

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

    • Jacqueline M Morano, Jamie L Uejima, Avery Tung, and Joshua M Rosenow.
    • Northwestern Memorial Hospital.
    • Curr Opin Anaesthesiol. 2023 Oct 1; 36 (5): 461467461-467.

    Purpose Of ReviewThe 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 FindingsIndications 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.SummaryAs 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.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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