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Anesth Analg 2006;103:1241-1249
© 2006 International Anesthesia Research Society
doi: 10.1213/01.ane.0000244532.71743.c6

NEUROSURGICAL ANESTHESIA

Vagal Nerve Stimulation: Overview and Implications for Anesthesiologists

Kevin W. Hatton, MD*, J. Thomas McLarney, MD*, Thomas Pittman, MD**, and Brenda G. Fahy, MD, FCCM*

From the Departments of *Anesthesiology and **Surgery, University of Kentucky Chandler Medical Center, Lexington, Kentucky.

Address correspondence and reprints requests to Kevin W. Hatton, MD, 800 Rose St., Lexington, KY 40536. Address e-mail to kwhatt2{at}email.uky.edu.

Vagal nerve stimulation is an important adjunctive therapy for medically refractory epilepsy and major depression. Additionally, it may prove effective in treating obesity, Alzheimer's disease, and some neuropsychiatic disorders. As the number of approved indications increases, more patients are becoming eligible for surgical placement of a commercial vagal nerve stimulator (VNS). Initial VNS placement typically requires general anesthesia, and patients with previously implanted devices may present for other surgical procedures requiring anesthetic management. In this review, we will focus on the indications for vagal nerve stimulation (both approved and experimental), proposed therapeutic mechanisms for vagal nerve stimulation, and potential perioperative complications during initial VNS placement. Anesthetic considerations during initial device placement, as well as anesthetic management issues for patients with a preexisting VNS, are reviewed.




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2006 by the International Anesthesia Research Society.