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British Journal of Anaesthesia, 2002, Vol. 89, No. 6 904-916
© 2002 The Board of Management and Trustees of the British Journal of Anaesthesia

Parkinson’s disease and anaesthesia

G. Nicholson*,1, A. C. Pereira2 and G. M. Hall1

1 Department of Anaesthesia and Intensive Care Medicine, St George’s Hospital Medical School, Cranmer Terrace, London SW17 0RE, UK. 2 Department of Neurology, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK

Abstract

Parkinson’s disease is an increasingly common disease of elderly patients who present a particular anaesthetic challenge. This review explores the epidemiology, aetiology, pathogenesis, and pathophysiology of the condition, particularly the possible role of genetic factors. The clinical features are described in detail and recent advances in medical management are highlighted. Controversies surrounding the use of the newer drugs and possible advances in neurosurgical interventions are discussed. Particular anaesthetic problems in patients with Parkinson’s disease are respiratory, cardiovascular, and neurological. Potential drug interactions are described and recommendations are made about suitable anaesthetic techniques.

Br J Anaesth 2002; 89: 904–16


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