Intraoperative Management of a Patient for Deep Brain Stimulation with Severe Dyskinesia and Tremors: Ketamine to the Rescue!

The loss of dopaminergic neurons from the substantia nigra pars compacta characterizes the classical pathology of Parkinson's disease (PD). Deep brain stimulation (DBS) has become an increasingly common treatment for PD. Sometimes excessive tremors due to exacerbated PD hinder the surgery and may almost make it impossible. This is a case report highlights use of IV ketamine for intraoperative sedation of a patient with PD, with severe dyskinesia & tremors, posted for DBS. IV ketamine resulted in prompt abolition of tremors and dyskinesia, which were unresponsive to previous traditional sedative drugs.