• Xiaodi Sun, Leyang Dai, Yinbing Pan, and Huanhuan Sha.
• Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing Jiangsu, P.R. China.
• Medicine (Baltimore). 2020 May 22; 99 (21): e20363.

RationaleParkinson disease (PD) is a chronic neurodegenerative condition often suffered by the elderly. Upper airway obstruction, though rare in patients with PD, can be life threatening and is associated with vocal cord paralysis, laryngeal spasm, and dystonia of jaw and neck muscles.Patient ConcernsWe describe a life-threatening upper airway obstruction caused by bilateral vocal cord paralysis, in an elderly man with PD, during extubation after general anesthesia.DiagnosesBased on clinical presentation and visual laryngoscopy, the patient was diagnosed with laryngeal spasm and bilateral vocal cord paralysis after extubation.InterventionsRe-intubation was carried out and dopamine hydrazine tablets were administered via a nasal feeding tube.OutcomesAfter re-intubation and further treatment, the endotracheal tube was successfully removed and no symptoms of respiratory distress were observed.LessonsPatients with PD may be at a risk of life-threatening upper airway obstruction after extubation, which should be prevented systematically.

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