The postanesthesia patient with Parkinson's disease

Parkinson's disease, or paralysis agitans, is a central nervous system disease. Concentrations of dopamine and acetylcholine, neurotransmitters in the substantia nigra of the basal ganglia, become imbalanced. Bradykinesia, rigidity, rhythmic head nodding, and pill-rolling motion of the thumb and forefinger are characteristic. Difficulty verbalizing, dementia, and depression are also common. Levodopa, the medication of choice, restores dopamine to brain cells, reducing parkinsonian symptoms. Awareness by the PACU nurse of the potential for systemic effects of dopamine is one important element of postanesthesia care for the patient with Parkinson's disease. In addition, recognition of the unique physical limitations and medication combinations for each patient promotes optimal postanesthesia nursing assessment and intervention.