What is the perioperative management of Parkinson disease medications?

Updated: Jan 09, 2018
  • Author: Nafisa K Kuwajerwala, MD; Chief Editor: William A Schwer, MD  more...
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Answer

Answer

Patients with Parkinson disease who take dopamine (combination of L-dopa and carbidopa) must stay on their usual medication schedule as much as possible perioperatively because no parenteral form of Sinemet is available and withholding the drug can cause a parkinsonian crisis. Anticholinergics, such as benztropine mesylate in a dose of 0.5-1 mg twice daily, may be given intramuscularly during the perioperative period without serious cardiovascular risk. L-dopa should be resumed postoperatively as soon as possible, and the patient should be carefully monitored for hypotension. [13]


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