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PD – Perioperative Medication — SCE Neurology MCQ

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EasyMovement DisordersPD – Perioperative MedicationSCE Neurology

A 65-year-old man with Parkinson's disease on co-careldopa is admitted for elective hip surgery. The orthopaedic team asks about perioperative PD management. What is the critical advice?

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Correct answer: C — Continue co-careldopa at usual times including morning of surgery, using dispersible formulation or NG tube if NBM

NICE NG71 mandates that dopaminergic medication must NEVER be omitted or delayed in PD patients. Abrupt withdrawal risks parkinsonism-hyperpyrexia syndrome. On the day of surgery, co-careldopa should be given with a sip of water, or via dispersible/NG route if NBM. A: Stopping is dangerous. C: IV levodopa is unavailable in the UK. D: Haloperidol is a dopamine antagonist and will worsen PD. E: Even 12 hours omission can cause severe deterioration.

Reference: NICE NG71 (2017); Parkinson's UK Get It On Time Campaign