Abstract

Advanced Parkinson disease presents unique perioperative considerations for the anesthesiologist primarily due to autonomic dysfunction. Postural hypotension, bradycardia, and supine hypertension are common manifestations of dysautonomia, which increase the incidence of perioperative adverse cardiovascular events. This retrospective study reveals that the incidence of adverse cardiovascular events in these patients during intraoperative period was 36% and the incidence in stage I DBS was 39% while the incidence in stage II DBS was 34%. Smoking, preoperative hypertension, renal failure, preoperative use of medications such as beta-blocker agents, calcium channel blockers and diuretics, as well as longer surgery duration are potential predictors for adverse cardiovascular events in this patient population.

Keywords

Bradycardia, Deep Brain Stimulation, Dysautonomia, Orthostatic Hypotension, Parkinson Disease