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

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.