Perioperative Treatment with High Dose Rotigotine and Amantadine Combination in a Patient with Advanced Stage Parkinson’s Disease After Esophagectomy

Current treatment for Parkinson’s disease (PD) includes: levodopa, dopamine agonists, monoamine oxidase type B inhibitors, catechol-O-methyltransferase inhibitors, amantadine, anticholinergics, clozapine and deep brain stimulation. A lot of patients with PD undergo surgery under general anesthesia for abdominal operations with a long fasting period. Interruption of antiparkinsonian drug therapy for long periods of time may worsen the PD symptoms. This is why parenteral substitution of antiparkinsonian medications during the complete fasting period is advised. Herein we present a case of a resistant to usual medication doses PD patient, who underwent total esophagectomy and was treated post- operatively with a combination of high dose rotigotine and amantadine.