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Sunday, November 23, 2014
Can anesthesia aggravate Parkinson`s Disease?
My father has not been diagnosed yet but has a significant tremor in his right arm. His neurologist said it is probably Parkinson`s Disease. Dad does not feel he needs medicine for it yet. He had his colon resected in `98 (stage III cancer). Now his cancer blood marker is rising and his oncologist says an operation would be too much of a risk for him because anesthesia can aggravate motion disorders permanently. Is this true for both local and general anesthesia? Dad had no problems with his previous colon resection operation. Thanks for your help.
Thank you for your interesting question. The short answer is that anesthesia can be safely administered to patients with Parkinson`s Disease.
In patients with Parkinson`s disease undergoing surgery, the administration of anesthesia does however require some special precautions. For example, anesthetic drugs that affect dopamine, (the brain chemical which is thought to be reduced in Parkinson`s disease), should probably be avoided. Secondly, problems can occur from the interaction of anesthetic agents with the drugs used to treat Parkinson`s disease. Finally, under anesthesia certain problems may occur more commonly in those affected by Parkinson`s disease than in healthy patients. These include increased or decreased blood pressure, irregular heartbeat, aspiration, and breathing difficulties.
Despite the aforementioned, we frequently administer both general and regional anesthesia to patients with Parkinson`s disease without causing any obvious harm to them. I am not aware of any studies that have documented a permanent worsening in movement disorder due to anesthesia - I would be very interested to learn of such a study. I think it may be unwise to deny a patient his needed cancer surgery on these grounds.
Remember to advise the anesthesiologist of your concerns, and consider asking for a pre-surgery consultation to discuss them.
Gareth S Kantor, MD
Assistant Professor of Anesthesiology
School of Medicine
Case Western Reserve University