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Anesthesia Management in a Low Weight Patient with Parkinson's Disease: A Case Report

Received: 21 June 2024     Accepted: 8 July 2024     Published: 23 July 2024
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Abstract

Background: Parkinson's disease (PD) is a progressive neurological disease related to the destruction of dopaminergic neurons in the substantia nigra, basket spot and other brain regions, which is mainly characterized by motor neurological disorders and non-motor neurological disorders. Middle-aged and elderly people are more common, with more women than men. Polypharmacy in PD patients may lead to potential interactions with anesthetic drugs, so perioperative management is very important. Case presentetion: An 80-year-old female with a medical history of PD weighing 28kg, planed to undergo elective peritoneoscopically assisted transvaginal uterine abdominal wall suspension under general anesthesia. Antiparkinsonian medications continued until just before the induction of anesthesia. Preoperative examinations were completed and they showed no obvious abnormality. Vital signs, train-of-four (TOF) and bispectral index (BIS) were monitored to guide the administration of anesthesia. Appropriate sedatives, analgesics, muscle relaxants and antiemetics were selected after fully assessed the patient's condition and drug interactions during the perioperative period. The patient successfully completed the surgery and discharged from hospital. Conclusions: General anesthesia (GA) is the main anesthesia method for patients with Parkinson's disease undergoing surgery. When patients with PD undergo surgery, the anesthesiologists should fully and carefully evaluate the patient's status and preoperative combination of medications. Perioperative drugs that aggravate Parkinson's disease should be avoided in order to facilitate a smooth recovery after surgery.

Published in International Journal of Anesthesia and Clinical Medicine (Volume 12, Issue 2)
DOI 10.11648/j.ijacm.20241202.11
Page(s) 70-72
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Parkinson's Disease (PD), Low Weight, Anesthesia Management

References
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[2] Ye H, Robak LA, Yu M, et al. Genetics and Pathogenesis of Parkinson's Syndrome. Annu Rev Pathol. 2023; 18: 95-121.
[3] Tolosa E, Garrido A, Scholz SW, et al. Challenges in the diagnosis of Parkinson's disease. Lancet Neurol. 2021; 20(5): 385-397.
[4] Bloem BR, Okun MS, Klein C. Parkinson's disease. Lancet, 2021; 397 (10291): 2284-2303.
[5] Deng H, Gao K, Jankovic J. The VPS35 gene and Parkinson's disease [J]. Mov Disord, 2013, 28(5): 569-575.
[6] Moisan F, Kab S, Mohamed F, et al. Parkinson disease male-tofemale ratios increase with age: French nationwide study and meta-analysis [J]. J Neurol Neurosur Psychiatry, 2016, 87(9): 952-957.
[7] Oichi T, Chikuda H, Ohya J, et al. Mortality and morbidity after spinal surgery in patients with Parkinson's disease: a retrospective matched-pair cohort study [J]. Spine J, 2017, 17(4): 531-537.
[8] Yim RLH, Leung KMM, Poon CCM, et al. Peri-operative management of patients with Parkinson's disease. Anaesthesia. 2022 Jan; 77 Suppl 1: 123-133.
[9] Gautam B, Baral B. Spinal anaesthesia for laparoscopic cholecystectomy in Parkinson's disease [J]. J Nepal Med Assoc, 2018, 56(211): 701-704. PMID: 30381769.
[10] Suttrup I, Warnecke T. Dysphagia in Parkinson's disease [J]. Dysphagia, 2016, 31(1): 24-32.
[11] Mastrangelo G, Comiati V, dell'Aquila M, et al. Exposure to anesthetic gases and Parkinson's disease: a case report [J]. BMC Neurol 2013, 13: 194.
[12] Burton D, Nicholson G, Hall G. Anaesthesia in elderly patients with neurodegenerative disorders: special considerations [J]. Drugs Aging, 2004, 21(4): 229-242.
[13] Wang S, Song T, Leng C, et al. Propofol protects against the neurotoxicity of 1 methyl 4 phenylpyridinium [J]. Mol Med Rep, 2016, 13(1): 309-314.
[14] Sherer J, Salazar T, Schesing K, et al. Diphenhydramine for acute extrapyramidal symptoms after propofol administration [J]. Pediatrics, 2017, 139(2): e20161135.
[15] Xu X, Yu X, Wu X, et al. Propofol requirement for induction of unconsciousness is reduced in patients with Parkinson's disease: a case control study [J]. Biomed Res Int, 2015, 2015: 953729.
[16] Wang J, Xu X, Yu X, et al. Remifentanil requirement for inhibiting responses to tracheal intubation and skin incision is reduced in patients with Parkinson's disease undergoing deep brain stimulator implantation [J]. J Neurosurg Anesthesiol, 2016, 28(4): 303-308.
[17] Bassani T, Vital M, Rauh L. Neuroinflammation in the pathophysiology of Parkinson's disease and therapeutic evidence of anti-inflammatory drugs [J]. Arq Neuropsiquiatr, 2015, 73(7): 616-623.
[18] Lertxundi U, Isla A, Solinís M, et al. Medication errors in Parkinson's disease inpatients in the Basque Country [J]. Parkinsonism Relat Disord, 2017, 36: 57-62.
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    Tu, H. (2024). Anesthesia Management in a Low Weight Patient with Parkinson's Disease: A Case Report. International Journal of Anesthesia and Clinical Medicine, 12(2), 70-72. https://doi.org/10.11648/j.ijacm.20241202.11

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    ACS Style

    Tu, H. Anesthesia Management in a Low Weight Patient with Parkinson's Disease: A Case Report. Int. J. Anesth. Clin. Med. 2024, 12(2), 70-72. doi: 10.11648/j.ijacm.20241202.11

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    AMA Style

    Tu H. Anesthesia Management in a Low Weight Patient with Parkinson's Disease: A Case Report. Int J Anesth Clin Med. 2024;12(2):70-72. doi: 10.11648/j.ijacm.20241202.11

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  • @article{10.11648/j.ijacm.20241202.11,
      author = {Hong Tu},
      title = {Anesthesia Management in a Low Weight Patient with Parkinson's Disease: A Case Report
    },
      journal = {International Journal of Anesthesia and Clinical Medicine},
      volume = {12},
      number = {2},
      pages = {70-72},
      doi = {10.11648/j.ijacm.20241202.11},
      url = {https://doi.org/10.11648/j.ijacm.20241202.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijacm.20241202.11},
      abstract = {Background: Parkinson's disease (PD) is a progressive neurological disease related to the destruction of dopaminergic neurons in the substantia nigra, basket spot and other brain regions, which is mainly characterized by motor neurological disorders and non-motor neurological disorders. Middle-aged and elderly people are more common, with more women than men. Polypharmacy in PD patients may lead to potential interactions with anesthetic drugs, so perioperative management is very important. Case presentetion: An 80-year-old female with a medical history of PD weighing 28kg, planed to undergo elective peritoneoscopically assisted transvaginal uterine abdominal wall suspension under general anesthesia. Antiparkinsonian medications continued until just before the induction of anesthesia. Preoperative examinations were completed and they showed no obvious abnormality. Vital signs, train-of-four (TOF) and bispectral index (BIS) were monitored to guide the administration of anesthesia. Appropriate sedatives, analgesics, muscle relaxants and antiemetics were selected after fully assessed the patient's condition and drug interactions during the perioperative period. The patient successfully completed the surgery and discharged from hospital. Conclusions: General anesthesia (GA) is the main anesthesia method for patients with Parkinson's disease undergoing surgery. When patients with PD undergo surgery, the anesthesiologists should fully and carefully evaluate the patient's status and preoperative combination of medications. Perioperative drugs that aggravate Parkinson's disease should be avoided in order to facilitate a smooth recovery after surgery.
    },
     year = {2024}
    }
    

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    AB  - Background: Parkinson's disease (PD) is a progressive neurological disease related to the destruction of dopaminergic neurons in the substantia nigra, basket spot and other brain regions, which is mainly characterized by motor neurological disorders and non-motor neurological disorders. Middle-aged and elderly people are more common, with more women than men. Polypharmacy in PD patients may lead to potential interactions with anesthetic drugs, so perioperative management is very important. Case presentetion: An 80-year-old female with a medical history of PD weighing 28kg, planed to undergo elective peritoneoscopically assisted transvaginal uterine abdominal wall suspension under general anesthesia. Antiparkinsonian medications continued until just before the induction of anesthesia. Preoperative examinations were completed and they showed no obvious abnormality. Vital signs, train-of-four (TOF) and bispectral index (BIS) were monitored to guide the administration of anesthesia. Appropriate sedatives, analgesics, muscle relaxants and antiemetics were selected after fully assessed the patient's condition and drug interactions during the perioperative period. The patient successfully completed the surgery and discharged from hospital. Conclusions: General anesthesia (GA) is the main anesthesia method for patients with Parkinson's disease undergoing surgery. When patients with PD undergo surgery, the anesthesiologists should fully and carefully evaluate the patient's status and preoperative combination of medications. Perioperative drugs that aggravate Parkinson's disease should be avoided in order to facilitate a smooth recovery after surgery.
    
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