Dorsal column stimulator placement4/9/2024 SCS implants have traditionally been performed with paresthesia mapping, which requires an awake and cooperative patient who will serve as a good monitor and alert the clinician in the case of needle or lead advancement into a nerve or the spinal cord. The Neurostimulation Appropriateness Consensus Committee (NACC) safety guidelines for the reduction of severe neurological injury recommend that the placement of percutaneous spinal cord stimulation (SCS) leads be performed in an awake and conversant patient. This survey should stimulate further research on this topic, given that the current safety guidelines and the rate of physicians reporting the use of deep sedation and general anesthesia for spinal cord stimulator placement remain at odds. SCS lead placement under deep sedation and general anesthesia appears to be common practice for many physicians who perform implants. This survey provides initial data on SCS practices among a large cohort of clinicians who utilize SCS. Additionally, 94% of physicians reported that they have never had a complication related to the use of general anesthesia for a spinal cord stimulator placement. Our findings demonstrate that 77% of physicians reported that they utilize deep sedation for permanent SCS implants at times, and 45% of physicians reported the use of general anesthesia for 10 kHz implants. Many practitioners frequently utilize deep sedation as well as general anesthesia when performing SCS implants. We analyzed the percent of respondents who indicated that they use deep sedation and general anesthesia during SCS placement as well as any reported complications. We conducted a survey of the active membership of the American Society of Regional Anesthesia and Pain Medicine (ASRA) and the Spine Intervention Society (SIS) regarding practice patterns with SCS therapy. This article presents the findings of a survey designed to answer this important question. It is not currently known how commonly this recommendation is adhered to by physicians in clinical practice. The Neurostimulation Appropriateness Consensus Committee (NACC) has recommended that the placement of percutaneous SCS leads be performed in an awake patient capable of providing feedback. Spinal cord stimulation (SCS) is a commonly utilized therapy for the treatment of neuropathic pain conditions.
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