Successful perioperative management of patients with Parkinson's disease following gastrointestinal surgery: report of three cases.
Parkinson's disease is a chronic progressive disease with symptoms of tremors, rigidity, and akinesia. Parkinson's disease is a major risk factor for postoperative complications and it is difficult to manage patients with Parkinson's disease after gastrointestinal surgery. This report presents the cases of three patients with Parkinson's disease who underwent gastrointestinal surgery and had no serious postoperative complications. Antiparkinsonian medications were reduced before surgery and replaced by an intravenous infusion of levodopa until the patients could take oral antiparkinson drugs after surgery to prevent malignant syndrome or exacerbate parkinsonism. Prokinetics were also used for the prevention of paralytic ileus. These cases demonstrate an effective method to administer antiparkinson drugs during perioperative management of patients with Parkinson's disease and also indicate that sufficient doses of antiparkinson drugs can control the symptoms of parkinsonism and prevent complications in cases of surgery with parkinsonism.
Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Gunma 371-8511, Japan.
Takaaki
T
Fujii
Toshihiro
T
Nakabayashi
Shinji
S
Hashimoto
Hiroyuki
H
Kuwano
D000368:Aged; D000978:Antiparkinson Agents / Q000008:administration & dosage*; D003082:Colectomy; D013505:Digestive System Surgical Procedures; D004305:Dose-Response Relationship, Drug; D005743:Gastrectomy; D006801:Humans; D008297:Male; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy*; D019990:Perioperative Care; D012004:Rectal Neoplasms / Q000150:complications / Q000601:surgery*; D013274:Stomach Neoplasms / Q000150:complications / Q000601:surgery*
D000978:Antiparkinson Agents