Management of vagus nerve stimulation therapy in the peri-operative period: Guidelines from the Association of Anaesthetists: Guidelines from the Association of Anaesthetists.

Autor: Broderick L; Beaumont Hospital, Dublin, Ireland., Tuohy G; Rotunda Hospital, Dublin, Ireland., Solymos O; St Vincent's University Hospital, Dublin, Ireland., Lakhani S; The Walton Centre NHS Foundation Trust, Liverpool, UK., Staunton B; Beaumont Hospital, Dublin, Ireland., Ennis P; Beaumont Hospital, Dublin, Ireland., Clark N; Bristol Children's Hospital, Bristol, UK., Moppett IK; University of Nottingham, UK., Chalissery A; Beaumont Hospital, Dublin, Ireland., Kilbride RD; Beaumont Hospital, Dublin, Ireland., Sweeney KJ; Beaumont Hospital, Dublin, Ireland., O'Brien D; Beaumont Hospital, Dublin, Ireland., O'Hare A; Beaumont Hospital, Dublin, Ireland., Harvey A; Royal Cornwall Hospital Trust, Cornwall, UK., Larkin CM; Beaumont Hospital, Dublin, Ireland.
Jazyk: angličtina
Zdroj: Anaesthesia [Anaesthesia] 2023 Jun; Vol. 78 (6), pp. 747-757. Date of Electronic Publication: 2023 Apr 25.
DOI: 10.1111/anae.16012
Abstrakt: Vagus nerve stimulation is a well-established treatment option for patients with drug-resistant epilepsy and has an expanding range of other clinical indications. Side effects of vagus nerve stimulation therapy include: cough; voice changes; vocal cord adduction; rarely, obstructive sleep apnoea; and arrhythmia. Patients with implanted vagus nerve stimulation devices may present for unrelated surgery and critical care to clinicians who are unfamiliar with their function and safe management. These guidelines have been formulated by multidisciplinary consensus based on case reports, case series and expert opinion to support clinicians in the management of patients with these devices. The aim is to provide specific guidance on the management of vagus nerve stimulation devices in the following scenarios: the peri-operative period; peripartum period; during critical illness; and in the MRI suite. Patients should be aware of the importance of carrying their personal vagus nerve stimulation device magnet with them at all times to facilitate urgent device deactivation if necessary. We advise that it is generally safer to formally deactivate vagus nerve stimulation devices before general and spinal anaesthesia. During periods of critical illness associated with haemodynamic instability, we also advise cessation of vagus nerve stimulation and early consultation with neurology services.
(© 2023 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists.)
Databáze: MEDLINE
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