Parkinson’s disease and autonomic instability

[PainDrain]

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Recently I had two case (both happened to be long ortho cases) where the patients had severe Parkinson’s dz and they were extremely labile during the case. I figured it was autonomic dysfunction related to their Parkinson’s; anyone have any experience with this?

 

[coffeebythelake]

Recently I had two case (both happened to be long ortho cases) where the patients had severe Parkinson’s dz and they were extremely labile during the case. I figured it was autonomic dysfunction related to their Parkinson’s; anyone have any experience with this?

Yes. Very common with Parkinsons.

 

[DrOwnage]

Yes. It helps with they are taking their parkinsons meds the day of surgery and shortly after on the same timeline.

 

[Beeftenderloin]

Had a pump case a couple weeks ago where patient had Parkinson’s. Dude was all over the place. It’s a thing.

 

[PainDrain]

I definitely knew it was possible and had read about it but I just never experienced it myself in practice. Interestingly and anecdotally, one case was a TIVA and the other used volatile; looking at the records the TIVA was definitely more stable than volatile.

 

[deleted1130227]

Lots of Parkinson's patients suffer from Shy-Drager syndrome. Ever notice that patients with moderate to severe Parkinson's disease are rarely on antihypertensives. Even if they needed them earlier in life.

 

[coffeebythelake]

Lots of Parkinson's patients suffer from Shy-Drager syndrome. Ever notice that patients with moderate to severe Parkinson's disease are rarely on antihypertensives. Even if they needed them earlier in life.

Don't confuse Parkinsons with Shy Drager / Multiple System Atrophy. Not the same. Not interchangeable terms. You either have one or the other.