title: [Perioperative Management of a Patient with Severe Parkinson's Disease with Intravenous Levodopa Administration].
abstract: A 70-year-old man with severe Parkinson's disease was scheduled for thoracic aortic aneurysm resection and aortic valve replacement. We administered levodopa intravenously during the perioperative period to avoid the malignant syndrome which is reported to arise with abrupt cessation of anti-Parkinson's drugs. The dose of intravenous administration was tapered with the resumption of oral intake. No manifestation of malignant syndrome was observed. We measured blood concentrations of levodopa several times during the perioperative period. The concentration of levodopa during the surgery was relatively high; however no adverse events of overdose (e.g. dyskinesis) occurred. In the postoperative period, administration of levodopa was changed to the oral route and serum levels of levodopa showed a notable decrease, the cause of which may be poor absorption through the digestive system during the perioperative period. Therefore, in the peri- and post-operative periods, it is necessary to take great care when reducing the infusion dose.
authors.forename: Satoko
authors.initials: S
authors.lastname: Terashima
authors.forename: Yurina
authors.initials: Y
authors.lastname: Yanagido
authors.forename: Akira
authors.initials: A
authors.lastname: Watabe
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yamane
authors.forename: Yuji
authors.initials: Y
authors.lastname: Morimoto
mesh_terms: D000368:Aged; D000978:Antiparkinson Agents / Q000008:administration & dosage*; D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000601:surgery*; D006801:Humans; D007262:Infusions, Intravenous; D007980:Levodopa / Q000008:administration & dosage*; D008297:Male; D010300:Parkinson Disease / Q000150:complications* / Q000188:drug therapy; D059035:Perioperative Period
chemical_list: D000978:Antiparkinson Agents; D007980:Levodopa