A remifentanil/ketamine sedation in surgical cancer patients having severe Parkinson’s disease: Two case reports

Authors

  • German Salazar, MD
  • Cyrus Motamed, MD

DOI:

https://doi.org/10.5055/jom.2012.0106

Keywords:

remifentanil, ketamine, Parkinson

Abstract

Symptoms of Parkinson’s disease are related to a progressive loss of substancia nigra’s dopaminergic neurons in addition to persistent activation of N-methyl- D-aspartate receptors. In specific situations such as sedation for minor surgery, tremor and dyskinesia can be very disabling. We report the beneficial effect of the combination of remifentanil (target-controlled infusion mode) and ketamine (boluses IV) to control dyskinesia and tremor for two elderly patients with Parkinson’s disease. The patients were scheduled for elective oncological plastic surgery under sedation, for which dyskinesia and tremor needed to be quickly abolished to permit surgery. Both procedures were completed with this drug combination resulting with no major side effects.

Author Biographies

German Salazar, MD

Institut Gustave Roussy, 39 Rue Camille Desmoulins, 94805 Villejuif, France.

Cyrus Motamed, MD

Institut Gustave Roussy, 39 Rue Camille Desmoulins, 94805 Villejuif, France.

References

Jocoy EL, André VM, Cummings DM, et al.: Dissecting the contribution of individual receptor subunits to the enhancement of N-methyl-D-aspartate currents by dopamine D1 receptor activation in striatum. Front Syst Neurosci. 2011; 5: 28.

Dyson SC, Barker RA: Cell-based therapies for Parkinson’s disease. Expert Rev Neurother. 2011; 11(6): 831-44.

Starr MS, Starr BS, Kaur S: Stimulation of basal and L-DOPA induced motor activity by glutamate antagonists in animal models of Parkinson’s disease. Neurosci Biobehay Rev. 1997; 21: 437-446.

Justin J. Wright, Peter D. Goodnight, et al.: The utility of ketamine for the preoperative management of a patient with Parkinson’s disease. Anesth Analg. 2009; 108: 980-982.

Published

03/01/2012

How to Cite

Salazar, MD, G., and C. Motamed, MD. “A remifentanil/Ketamine Sedation in Surgical Cancer Patients Having Severe Parkinson’s Disease: Two Case Reports”. Journal of Opioid Management, vol. 8, no. 2, Mar. 2012, pp. 133-4, doi:10.5055/jom.2012.0106.

Issue

Section

Case Studies