Abstract
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.
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References
Pepper PV, Goldstein MK. Postoperative complications in Parkinson’s disease. J Am Geriatr Soc 1999;47:967–972.
Simon D, Shapira OM, Mor E, Pfefferman R. Parkinson syndrome. a significant risk factor in the patient with acute surgical disorder. Int Surg 1992;77:313–316.
Galvez-Jimenez N, Lang AE. Perioperative problems in Parkinson’s disease and their management: apomorphine with rectal domperidone. Can J Neurol Sci 1996;23:198–203.
Ali GN, Wallace KL, Schwartz R, DeCarle DJ, Zagami AS, Cook IJ. Mechanism of oral-pharyngeal dysphagia in patients with Parkinson’s disease. Gastroenterology 1996;110:383–392.
Singaram C, Ashraf W, Gaumnitz EA, Torbey C, Sengupta A, Pfeiffer R, Quigley EM. Dopaminergic defect of enteric nervous system in Parkinson’s disease patients with chronic constipation. Lancet 1995;30:861–864.
Edwards LL, Quigley EM, Harned RK, Hofman R, Pfeiffer RF. Characterization of swallowing and defecation in Parkinson’s disease. Am J Gastroenterol 1994;89:15–25.
Byrne KG, Pfeiffer R, Quigley EM. Gastrointestinal dysfunction in Parkinson’s disease. A report of clinical experience at a single center. J Clin Gastroenterol 1994;19:11–16.
Furuya R, Hirai A, Andoh T, Kudoh I, Okumura F. Successful perioperative management of a patient with Parkinson’s disease by enteral levodopa administration under propofol anesthesia. Anesthesiology 1998;89:261–263.
Hoehn MM, Yahr MD. Parkinsonism: onset, progression, and mortality. Neurology 1967;17:427–442.
Mochiki E, Asao T, Kuwano H. Gastrointestinal motility after digestive surgery. Surg Today 2007;37:1023–1032.
Ikebe S, Harada T, Hashimoto T, Kanazawa I, Kuno S, Mizuno Y, et al. Prevention and treatment of malignant syndrome in Parkinson’s Disease: a consensus statement of the malignant syndrome research group. Parkinsonism Relat Disord 2003;9suppl 1:S47–S49.
Contin M, Riva R, Martinelli P, Cortelli P, Albani F, Baruzzi A. Pharmacodynamic modeling of oral levodopa. Neurology 1993;43:367–371.
Minsker DH, Scriabine A, Stokes AL. Effects of L-dopa alone and in combination with dopa decarboxylase inhibitors on the arterial pressure and heart rate of dogs. Experientia 1971;27:529–531.
Rosin AJ, Devereux D, Eng N, Calne DB. Parkinsonism with ‘on-off’ phenomena. Intravenous treatment with levodopa after major abdominal surgery. Arch Neurol 1979;36:32–34.
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Fujii, T., Nakabayashi, T., Hashimoto, S. et al. Successful perioperative management of patients with Parkinson’s disease following gastrointestinal surgery: Report of three cases. Surg Today 39, 807–810 (2009). https://doi.org/10.1007/s00595-008-3938-9
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DOI: https://doi.org/10.1007/s00595-008-3938-9