Going into hospital for surgery

If you are having surgery for something not connected to your Parkinson’s, make sure the healthcare professionals involved know about your condition.

This will mean that anything about your Parkinson’s that could create problems, such dystonia or a tremor, can be taken into account so you can still be treated properly.

If you need to have an emergency operation, it is important that the healthcare team looking after you know you have Parkinson’s as soon as possible.

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You will usually meet your anaesthetist on the ward before your surgery. It is very important that your anaesthetist knows you have Parkinson’s and what medication you take for the condition.

Some anaesthetics may make Parkinson’s symptoms worse or interfere with Parkinson’s medication. The anaesthetist can plan your care appropriately around this.

When you meet the anaesthetist they will go through your answers to the pre-admission questions. They will also discuss your Parkinson’s symptoms and how they may affect you during surgery, as well as explaining any risks or side effects of the drugs you might have.

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Can I keep taking my Parkinson's medication right up until the time of surgery?

It’s important that you can keep taking your Parkinson’s medication as close to your surgery as possible, and as soon as possible after the operation.

You may be asked not to eat or drink for a period of time before the operation (‘nil by mouth’). But you are usually allowed to keep taking your medication with a few sips of water during this period. Your anaesthetist will discuss plans for this with you before your operation.

If you have Parkinson’s, your surgery may be put at the start of the day’s operating schedule. This can mean that the risk of the surgery being cancelled is lower, for example if other procedures take longer than expected.

Organising your medication regime is also easier if you know what time your surgery will be in advance.

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Medication may be given during surgery if your operation is taking longer than planned and there is a risk of missing a dose.

Levodopa

If you usually take levodopa, it may be possible to give you your dose using a tube that goes into your stomach. You should discuss this with your anaesthetist.

Apomorphine

Depending on the procedure, you may not be able to take your usual oral medication after surgery. But it may be possible to use different drugs, such as apomorphine. It is a strong dopamine agonist and can be taken by intermittent injection, or via infusion using a pump.

Your healthcare team should discuss the option of apomorphine after surgery with you before you go into hospital. Your Parkinson’s specialist will also be involved in the decision.

If this is not discussed with you, ask your healthcare professional to talk to you about apomorphine.

Dopamine agonists

If you normally take oral dopamine agonists and are nil by mouth due to surgery, you may be switched to a dopamine agonist patch. The patch is applied to your skin and, once in place, lasts for 24 hours.

It will deliver the same dose of medication as you would normally take orally. Your specialist can advise your surgical team about this.

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Low blood pressure

Having Parkinson’s can cause people to have higher blood pressure readings when lying flat. If you experience this symptom, you should tell your anaesthetist.

Involuntary movements (dyskinesia)

Dyskinesia are involuntary movements of the arms, legs, body or hands that can’t be controlled. It is a side effect of some Parkinson’s drugs when they have been used for a long time.

Involuntary movements may affect procedures such as x-rays, scans or radiotherapy, when you need to keep still. Radiographers usually have techniques such as putting foam wedges in place to help overcome this, but it is important to talk to your healthcare professional about your movement problems before any procedure. You may need to have a general anaesthetic or be sedated so you are able to keep still.

Saliva control and swallowing problems

Some people with Parkinson’s develop problems controlling their saliva, which can lead to drooling or dribbling. The medical term for this is sialorrhoea.

If you experience these symptoms and are having a general anaesthetic, you may need to have a tube put down your throat to help you breathe. This is called intubation. This allows the anaesthetist to make sure your airway stays clear during the surgery.

Speak to your healthcare professional if you have any concerns about saliva control or swallowing problems during surgery.

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Last updated February 2020. We review all our information within 3 years. If you'd like to find out more about how we put our information together, including references and the sources of evidence we use, please contact us at [email protected]