Parkinson's disease and anaesthesia.
Parkinson's disease is an increasingly common disease of elderly patients who present a particular anaesthetic challenge. This review explores the epidemiology, aetiology, pathogenesis, and pathophysiology of the condition, particularly the possible role of genetic factors. The clinical features are described in detail and recent advances in medical management are highlighted. Controversies surrounding the use of the newer drugs and possible advances in neurosurgical interventions are discussed. Particular anaesthetic problems in patients with Parkinson's disease are respiratory, cardiovascular, and neurological. Potential drug interactions are described and recommendations are made about suitable anaesthetic techniques.
Nicholson
G
G
Department of Anaesthesia and Intensive Care Medicine, St George's Hospital Medical School, Cranmer Terrace, London SW17 0RE, UK. gnichols@sghms.ac.uk
Pereira
A C
AC
Hall
G M
GM
D000758:Anesthesia / Q000009:adverse effects / Q000379:methods*; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008996:Monoamine Oxidase Inhibitors / Q000627:therapeutic use; D009294:Narcotics; D010300:Parkinson Disease / Q000209:etiology / Q000503:physiopathology / Q000601:surgery / Q000628:therapy
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008996:Monoamine Oxidase Inhibitors; D009294:Narcotics; D007980:Levodopa