Scalp block improves electrophysiological stability and patient cooperation during deep brain stimulation surgery

Deep Brain Stimulation (DBS) is a critical intervention for various neurological disorders. While effective, the traditional local infiltration anesthesia used in DBS surgeries often hinders electrophysiological recording quality and patient cooperativeness. The research aims to evaluate the impact of local infiltration versus scalp block anesthetic methods on electrophysiological signal quality and patient cooperativeness during DBS surgeries. This study involved patients who participated in an intraoperative task during the bilateral subthalamic nucleus DBS surgery for Parkinson's Disease between Jan 2020 and Dec 2022. Patients were either administered the traditional local infiltration anesthesia or the modified scalp block anesthesia. Intraoperative electrophysiological recording data and anesthetic data was collected. Spike sorting was performed to evaluate the recording stability. Patient cooperativeness and intraoperative experience was assessed and compared. The patients under scalp block anesthesia exhibited shorter pre-acquisition time, longer stable recording time, higher number of tasks per site, higher number of neurons recorded per task (all ps < 0.05). In behavior, patients under scalp block anesthesia showed higher accuracy in tasks (p < 0.05), while the response time was comparable. The overall satisfaction of anesthesia was also higher in scalp block, as revealed by the visual analogue scale, Likert scale and mean arterial pressure (all ps < 0.05). The modified scalp block anesthetic method offers considerable advantages over traditional local infiltration anesthesia in DBS surgeries. It helps to improve both patient comfort and cooperation during the surgery, and thereby enhancing the overall quality of neurological data and efficacy of DBS procedures.