The subject SHOULD have been ...poorly managed pre/post op. Peri meaning
just before and just after...
--
Judith Richards, London, Ontario, Canada
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^^^^
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-----Original Message-----
From: judith richards <[log in to unmask]>
To: .Parkinsn <[log in to unmask]>
Date: Tuesday, August 03, 1999 12:56 AM
Subject: NEWS-Parkinson's disease poorly managed post-op
> Parkinson's disease poorly managed perioperatively
>
>VANCOUVER, Aug 02, 1999 (Reuters Health) - Patients with Parkinson's
>disease (PD) say that their disease is poorly managed in-hospital when
>they undergo surgery for other conditions, investigators reported here
>at the 13th International Congress on Parkinson's Disease.
>
>Dr. David Stewart and colleagues at the Victoria Infirmary in Glasgow,
>Scotland, analyzed the results of questionnaires completed by patients
>with PD who underwent operations for unrelated conditions. Patients'
>caregivers also filled out questionnaires.
>
>The investigators obtained data from 125 procedures (neurologic,
>ophthalmologic, orthopedic, urologic, and general surgery) undergone by
>92 patients. Patients' mean age was 70.7 years, and the mean duration
of
>PD was 8.6 years.
>
>Overall, patients and their caregivers said that they were unhappy with
>the way PD was managed after 31% of the operations. Problems with
>medication timing or omission after the operation were reported in 37
>(30%) of the operations.
>
>"A possible reason for the problems with medication timing or omission
>is that patients' overall functioning can vary greatly throughout the
>day, and a number of patients felt that the nurses could see that they
>were capable of doing things for themselves at some point in the day,"
>Dr. Stewart suggested. "What happens is that later on in the day when
>patients were perhaps incapable of doing things for themselves and
asked
>the nurses for help, the nurses were sometimes suspicious and hesitant
>to assist."
>
>Of the 37 operations in which patients and caregivers cited problems
>with drug timing or omission, 31 cases (84%) resulted in PD
>complications compared with 32 of the 88 (36%) procedures in which no
>problems were reported with drug administration.
>
>Dr. Stewart said he is currently working on guidelines that will help
>surgeons, anesthesiologists, and nurses on the perioperative management
>of PD.
>
>Elsewhere at the meeting, a group from the University of British
>Columbia, in Vancouver, reported the results of a study of patients
with
>PD who were selected for unilateral pallidotomy based on their motor
>symptoms. The study showed that the procedure significantly decreases
>PD-related pain.
>
>Overall, 42% of 50 patients described pain related to PD prior to
>pallidotomy. Preoperative scores for pain were significantly reduced at
>both 6 weeks and 1 year following pallidotomy.
>
>The investigators identified four primary types of PD-related pain:
>somatic pain exacerbated by the disease, musculoskeletal pain, pain
>associated with dystonic movements, and dysesthetic pain. A few
patients
>had more than one type of pain. Exacerbations of somatic pain and
>musculoskeletal pain responded to treatment more than dystonic and
>dysesthetic pain.
>
>Study leader Dr. C. R. Honey said that 15% to 46% of PD patients have
>pain attributable to their disease.
>
>Copyright 1999 Reuters Limited.
>--
>Judith Richards, London, Ontario, Canada
>[log in to unmask]
> ^^^^
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