SCS implants have traditionally been performed with paresthesia mapping, which requires an awake and cooperative patient. SCS is considered to be a safe therapy for chronic pain conditions with a low incidence of serious adverse events. SCS provides pain relief by modulation of the pain pathway using electrical current through electrode leads. ![]() However, recent advances have broadened the scope of SCS therapy for a variety of other neuropathic pain conditions. The primary indication for SCS therapy is for the treatment of post-laminectomy syndrome as well as complex regional pain syndrome (CRPS). Spinal cord stimulation (SCS) is an increasingly utilized therapy that is effective for the treatment of refractory chronic neuropathic pain conditions. This survey provides initial data on the practice parameters of physicians who utilize SCS therapy including the use of deep sedation and general anesthesia when performing SCS implants, as well as complications associated with the use of anesthesia. There are risks and benefits when placing SCS leads in both awake patients and patients under deep sedation and general anesthesia. The advent of anatomic lead placement without the need for paresthesia overlap and the increasing availability of intraoperative neuromonitoring allows for the option of elective deep sedation and general anesthesia for placement of percutaneous SCS leads. ![]() 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.
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