title: The utility of ketamine for the preoperative management of a patient with Parkinson's disease.
abstract: Loss of dopaminergic neurons from the substantia nigra characterizes the classical pathology of Parkinson's disease, but persistent activation of N-methyl-D-aspartate receptors is also a major component. During difficult airway management in a patient with advanced Parkinson's disease, the use of low-dose (20 mg) i.v. ketamine resulted in complete abolition of severe tremor and dysarthria. This led to the current case report in which low-dose ketamine was used for preoperative sedation and dyskinesia attenuation. Prior research and our experience would suggest that low-dose ketamine, titrated to effect, may provide optimal patient comfort and perioperative control of Parkinsonian tremor.
authors.affiliation: MUSC, Department of Anesthesia and Perioperative Medicine, 167 Ashley Ave., PO Box 250912, Charleston, SC 29425, USA.
authors.forename: Justin J
authors.initials: JJ
authors.lastname: Wright
authors.forename: Peter D
authors.initials: PD
authors.lastname: Goodnight
authors.forename: Matthew D
authors.initials: MD
authors.lastname: McEvoy
mesh_terms: D000769:Anesthesia, Inhalation; D000778:Anesthetics, Dissociative; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D007649:Ketamine; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000628:therapy*; D019990:Perioperative Care; D011229:Preanesthetic Medication
chemical_list: D000778:Anesthetics, Dissociative; D007649:Ketamine