1992
DOI: 10.1213/00000539-199211000-00037
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Intraoperative Exacerbation of Parkinson??s Disease

Abstract: arkinson's disease afflicts approximately 1 % of the population over 50 yr old (1). Its associated P muscle tremors and rigidity are progressive and become severe enough to debilitate many patients. We summarize a case of advanced Parkinson's disease with an intraoperative exacerbation during regional anesthesia. A discussion of its consequences and treatment follow. Case ReportA 73-yr-old man with Parkinson's disease required anesthesia for repair of a large recurrent left inguinal hernia. His Parkinson's dis… Show more

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Cited by 19 publications
(9 citation statements)
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“…Most of the literature describes measures with regard to PD medication in the intraoperative period. To prevent large descents of dopamine levels intra‐ and postoperatively many authors advise continuation of PD medication as long as possible preoperatively and resume it as soon as possible postoperatively, and PD medication is preferably continued 6, 8, 25, 34, 37, 38, 42, 67–70, 72–74, 76, 78, 79, 81, 82, 84–92. Two studies on this topic describe PD patients using the rotigotine transdermal patch, a nonergot D1/D2/D3 dopamine agonist 81, 82.…”
Section: Resultsmentioning
confidence: 99%
“…Most of the literature describes measures with regard to PD medication in the intraoperative period. To prevent large descents of dopamine levels intra‐ and postoperatively many authors advise continuation of PD medication as long as possible preoperatively and resume it as soon as possible postoperatively, and PD medication is preferably continued 6, 8, 25, 34, 37, 38, 42, 67–70, 72–74, 76, 78, 79, 81, 82, 84–92. Two studies on this topic describe PD patients using the rotigotine transdermal patch, a nonergot D1/D2/D3 dopamine agonist 81, 82.…”
Section: Resultsmentioning
confidence: 99%
“…L-dopa is absorbed from the proximal gut and therefore rectal route is not helpful for the administration of the drug. [12] We administered oral L-dopa 30 minutes before the start of surgery as it has a very short half life (1-3 hours), and we again repeated the dose 2 hours after the surgery with a sip of water.…”
Section: Discussionmentioning
confidence: 99%
“…The half-life of levodopa is 1–3 h and so interruption should be as brief as possible, and therapeutic administration should be continued through the morning of surgery with sips of water. [12] As it is absorbed from the proximal small bowel and thus has to first traverse the stomach making administration of tablets through gastric tube suboptimal or ineffective, because patients with Parkinson's often have delayed gastric emptying. As such a duodenal feeding tube may be necessary when a prolonged period of normal feeding is expected.…”
Section: Drug Interactionsmentioning
confidence: 99%