Holmes tremor is characterized by irregular resting, postural and intention tremors. Deep brain stimulation (DBS) is an effective treatment. A 34-year-old man with Holmes tremor, secondary to head trauma, became agitated during DBS performed under local anesthesia. Remifentanil 0.03 µg/kg/min provided effective sedation and DBS was safety and successful performed.J Curr Surg. 2015;5(4):207-208doi: http://dx.doi.org/10.14740/jcs288e