What is the interaction between Spinal Cord Stimulators (SCS) and anesthesia?

Patients with spinal cord stimulators (SCS) can safely undergo anesthesia with proper precautions. The anesthesia team should be informed about the presence of an SCS before any procedure. For most surgeries, the stimulator should be turned off before entering the operating room to prevent electromagnetic interference with monitoring equipment and electrosurgical units. MRI procedures require special protocols depending on whether the SCS system is MRI-conditional. During procedures requiring electrocautery, the current path should be positioned as far from the stimulator and leads as possible, with bipolar cautery preferred when feasible. Postoperatively, the stimulator can typically be reactivated once the patient is stable, though programming adjustments may be needed. Patients should bring their stimulator remote control to the hospital and consult with their pain management physician before elective procedures. The primary concerns with SCS during anesthesia include potential damage to the device from electromagnetic interference, inaccurate readings on monitoring equipment, and possible movement of the leads during positioning. Most modern SCS systems are compatible with standard anesthesia practices when these precautions are observed.