Parkinson’s & Surgery

Maria Christina Ospina, MD

Movement Disorder Neurologist

(602) 277-2228

 

Print this article and take it with you to appointments with surgeons, pre-op appointments, dentist appointments and on the day of surgery.  These are some helpful hints for your medical care team about Parkinson disease, surgery, hospitalization and anesthesia.

Parkinson’s  Disease Patients and Surgery

  • Do not give Demerol or Codeine! Ever!

A single dose of either of these medications has, on many occasions, lead to hallucinations for several months in people with Parkinson’s.

  • Use local anesthetics for cataract and dental surgeries if at all possible.
  • Use spinal anesthetics for hip and back surgeries if at all possible.
  • Parkinson’s patients are prone to fluctuations in blood pressure, this can be tied to their Parkinson disease and not cardiac issues.
  • People with Parkinson’s are more susceptible to the post operative confusion and memory impairment that may be seen after general anesthesia. Depression is also quite common and if untreated can hinder the patient’s recovery. Speech and occupational therapy can be helpful.  Prevention of these complications will greatly reduce the patients stay in the hospital and improve the benefit gained from rehab.
  • Do not discontinue or skip the Parkinson’s medications!!!
    • If the patient was NPO for major surgery, resume Parkinson’s medications even when the patient is in the recovery room. When the patient can tolerate it, a single dose of Parcopa 25/100mg can be given under the tongue and repeated every 4 hrs.
    • To avoid potential pitfalls it is important to keep the patient’s regimen as uninterrupted as possible. Parkinson’s patients are at greater risk for aspiration because they may have trouble swallowing. Trouble swallowing may also lead to poor nutrition and therefore delay in wound healing.

Parkinson’s patients and families have worked hard to achieve a balance with their Parkinson’s medications. Stopping these meds can push them back months in their treatment.

Most of our patients and families understand their medications and how they work. They will be happy to share their personal experiences in managing their Parkinson’s Disease after surgery.  If you have any questions please do not hesitate to contact their Parkinson’s doctor.

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