title: Nasogastric medication for perioperative Parkinson's rigidity during anaesthesia emergence.
abstract: We present a case of severe rigidity during emergence from general anaesthesia in a 64-year-old man who had suffered from Parkinson's disease for nine years. Controversy still exists over how to optimally manage these patients perioperatively. We successfully managed his Parkinsonism with administration of crushed Sinemet" and amantadine via a nasogastric tube. This case report serves as a reminder of the importance that patients receive their anti-Parkinsonian medications perioperatively, and highlights the potential benefits of inserting a gastric tube to continue anti-Parkinson's medication dosing during prolonged surgery.
authors.affiliation: Department of Anaesthesia, Gold Coast Hospital, Robina Campus, Gold Coast, Queensland, Australia. Philip.stagg@gmail.com
authors.forename: P
authors.initials: P
authors.lastname: Stagg
authors.forename: T
authors.initials: T
authors.lastname: Grice
mesh_terms: D000547:Amantadine / Q000008:administration & dosage / Q000627:therapeutic use; D000758:Anesthesia; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General; D000978:Antiparkinson Agents / Q000627:therapeutic use*; D002230:Carbidopa / Q000008:administration & dosage / Q000627:therapeutic use; D004338:Drug Combinations; D005593:Fracture Fixation, Internal; D050723:Fractures, Bone / Q000601:surgery; D006801:Humans; D006811:Humerus; D058926:Intraoperative Awareness; D007441:Intubation, Gastrointestinal; D007980:Levodopa / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009127:Muscle Rigidity / Q000188:drug therapy*; D010300:Parkinson Disease / Q000188:drug therapy*; D019990:Perioperative Care
chemical_list: D000978:Antiparkinson Agents; D004338:Drug Combinations; C009265:carbidopa, levodopa drug combination; D007980:Levodopa; D000547:Amantadine; D002230:Carbidopa