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Vagal nerve stimulator (VNS) generator replacements continue to increase given the various indications of the device since its FDA approval in 1997. VNS generator replacements are usually safe and serious cardiac complications are not typically encountered during VNS generator replacement surgeries. We present a rare case of VNS generator replacement complicated by asystole and laryngospasm while exploring the plausible factors contributing to these events in our patient. The general recommendations to prevent and manage VNS therapy-related complications in the perioperative setting are described along with the safety strategies specific to VNS generator replacement procedures.
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Manohar et al. (2025) studied this question.
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