|
| Indication | Medication/treatment | Special considerations |
|
| Pain prevention | Intravenous paracetamol 1 g with dexamethasone 12 mg, unless fasting blood sugar >120 mg/dl | One hour before the procedure |
| Nausea prevention | Intravenous granisetron 3 mg or ondansetron 4 mg, or metoclopramide hydrochloride 10 mg in essential tremor patients. If protracted, dexamethasone 12 mg, unless fasting blood >120 mg/dl | One hour before treatment |
| Pain from pressure of the silicone membrane | EMLA lubrication of the skull before fitting the silicone membrane | 30 minutes before membrane placement |
| Pain from pins of the head frame | Locally injected lidocaine 2% and bupivacaine 0.5%, at each pin site | Immediately before pin insertion |
| Backache | Usually not needed. May administer intravenous paracetamol 1 g, dipyrone 1 g, or ketorolac 30 mg | Use of specialized cushion that flexes legs and reduces pressure on the lower back |
| Neck pain | Usually not needed. May administer intravenous paracetamol 1 g, dipyrone 1 g, or ketorolac 30 mg | Use of small cushion below the neck |
| Anxiety | None | Employing nonpharmacologic strategies |
| Nausea during treatment | Intravenous ondansetron 4 mg | A few drops of lemon juice may be tried |
| Vomiting | Suction | Urgent call for help |
| Vertigo | None | Reassurance since transient |
| Miscellaneous | Oxygen 2-3 l/min via the nasal prong. Emergency stop button that shuts down sonication and calls for help is given to the patient | — |
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