Anesthesia for parkinsons patient

[Linemanswife14]

Question.. so my father is going in for another heart cath. His body doesn't react well to anesthesia and it always stays with him for a long period of time. He has parkinsonisms and is on sinemet to control his symptoms.

The last cath he had back in September did not go well. They used a mild anesthesic on him and he was in the hospital for 2 weeks afterwards. Problems started with him not being able to urinate after the procedure so a foley was inserted, and he had to stay at the hospital overnight. During the night he became very confused and had to be given Ativan which made things worse over time. He then developed a UTI and had positive blood cultures and then developed cdiff from all the abx he was on. If anyone has any input, please share.

[Triddin]

We can't really offer medical advice per our tos

[Linemanswife14]

Sorry, don't think I was clear on what I was looking for. I'm asking if anyone knows of something, such as a mild anesthetic, that has been given to parkinsons pt.'s (who needed to have a heart cath) without them having lasting side effects afterwards.

[Davey Do]

Sorry, don't think I was clear on what I was looking for. I'm asking if anyone knows of something, such as a mild anesthetic, that has been given to parkinsons pt.'s (who needed to have a heart cath) without them having lasting side effects afterwards.

Yeah- that's something your father needs to discuss with his care provider.

The best to you, Linemanswife!

[nrsang97, BSN, RN]

Please discuss this with the anesthesia provider prior to your dad's heart cath. None of us here can answer these questions here for you as it IS giving medical advice and against terms of service.

[MunoRN, RN]

It's a reasonable scenario to discuss as a general situation since it actually does come up fairly frequently, so as a general nursing topic the issue of how to manage procedural sedation in a patient with Parkinsonian tremors and spasticity is challenging. As you might imagine, having a sheath in a groin, that may be between 6 and 16 French, doesn't go well with unexpected gross motor movement of the legs. The fact that Parkinson's patients are often on Sinemet doesn't help, since Sinemet is known to cause various delirium symptoms particularly when combined with benzodiazepines (versed in particular). As a result, anesthesiologist managed sedation is often required for Parkinson's patients when other patients may typically only require nurse managed procedural sedation. In the end, the increased complexity of procedural sedation management in Parkinson's patients should be carefully weighed against the expected benefits of the procedure.

[dianah, ASN]

You did clarify specifically what information you sought.

And it IS a fine line between asking for pertinent information and asking for medical advice.

My first impression was, to discuss the issue (in historical perspective, given his last experience) with the MD who is to perform the cath, AND with the MD who manages his Parkinsons. Perhaps a conference between the three of you will result in a plan amenable to all and, most importantly, safe for your dad.

Risk VS benefit.

Some Cardiologists are skilled at doing cardiac catheterizations from the radial approach, which would spare your dad having to lie with his legs still for a few hours afterwards.

Typically (unless the patient requires MAC or GA), cardiac caths are done with moderate sedation, administered by the RN staff.

Again, I urge you to discuss these issues with your dad's providers, and I wish you (and him) well. He is indeed lucky to have caring and attentive family looking out for him.

Closing this for now.