Spinal versus General Anesthesia for Patients with Parkinson's Disease

Diab A Bani Hani; Abdelwahab J Aleshawi; Majd H Al Shalakhti; Alaa''a Alhowary; Osama Al-Jararahih; Abdel-Hameed Al-Mistarehi; Ahmed Yassin

doi:10.2147/IJGM.S232770

Spinal versus General Anesthesia for Patients with Parkinson's Disease

Int J Gen Med. 2020 Jan 30:13:9-15. doi: 10.2147/IJGM.S232770. eCollection 2020.

Authors

Diab A Bani Hani¹, Abdelwahab J Aleshawi², Majd H Al Shalakhti², Alaa''a Alhowary¹, Osama Al-Jararahih³, Abdel-Hameed Al-Mistarehi², Ahmed Yassin⁴

Affiliations

¹ Department of Anesthesia and Recovery, Faculty of Medicine, Jordan University of Science and Technology, Irbid 21110, Jordan.
² Faculty of Medicine, Jordan University of Science and Technology, Irbid 21110, Jordan.
³ Division of Orthopedics, Department of Special Surgery, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan.
⁴ Division of Neurology, Department of Neuroscience, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan.

Abstract

Background: Anesthesiologists prefer using general anesthesia (GA) in Parkinson's disease (PD). However, GA may mask neurological symptoms in the intraoperative period and exacerbate them postoperatively. Furthermore, the anesthetics used in GA have clear interactions with the drugs used to control PD. On the other hand, drugs used in spinal anesthesia (SA) might be safer for patients with PD. The aim of this study is to evaluate the effect of SA and GA in patients with PD who underwent hip fracture repairs.

Methods: Retrospectively, we identified those patients with PD who were admitted due to hip joint fracture. The following information were obtained: demographics, preoperative assessment information of the patients, type of anesthesia, and types of fractures and orthopedic procedures. In addition, intraoperative and postoperative complications were studied. The patients were divided based on the type of anesthesia received and were compared.

Results: Ten (8 males) patients with PD who underwent hip fracture surgery included in the study. Six patients received SA and 4 patients received GA. The mean age was 73.2 years. The preoperative assessment was not significant for all patients. Postoperatively, within the inpatient period, 3 out of 4 patients received GA developed complications (two atelectasis and urinary tract infection) while no patient developed complication from the SA group. Postoperative outpatient complications within one-month included 3 out of 4 cases in the GA group and only one complication in the SA group. The mean hospitalization period was 9 days for patients received GA and 5.8 days for patients received SA.

Conclusion: This study reported less perioperative complications in the SA. Accordingly, further investigations and rp-randomized controlled trials evaluating various anesthetic techniques or drugs are needed.

Keywords: Parkinson’s; postoperative; propofol; spinal anesthesia.