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Anesthesia and analgesia · Mar 2009
Case ReportsThe utility of ketamine for the preoperative management of a patient with Parkinson's disease.
- Justin J Wright, Peter D Goodnight, and Matthew D McEvoy.
- MUSC, Department of Anesthesia and Perioperative Medicine, 167 Ashley Ave., PO Box 250912, Charleston, SC 29425, USA.
- Anesth. Analg. 2009 Mar 1;108(3):980-2.
AbstractLoss of dopaminergic neurons from the substantia nigra characterizes the classical pathology of Parkinson's disease, but persistent activation of N-methyl-D-aspartate receptors is also a major component. During difficult airway management in a patient with advanced Parkinson's disease, the use of low-dose (20 mg) i.v. ketamine resulted in complete abolition of severe tremor and dysarthria. This led to the current case report in which low-dose ketamine was used for preoperative sedation and dyskinesia attenuation. Prior research and our experience would suggest that low-dose ketamine, titrated to effect, may provide optimal patient comfort and perioperative control of Parkinsonian tremor.
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