• Continuous intravenous infusion of levodopa was used for eight days to manage a parkinsonian patient with "on-off" fluctuations who underwent abdominoperineal resection for carcinoma of the rectum. Reasonable control of parkinsonism was obtained initially with small doses of levodopa, but more than 4 g daily were eventually required. No adverse effects on cardiac rhythm, blood pressure, or gastrointestinal function occurred. Frequent adjustment of levodopa dosage was necessary in view of continuing "on-off" fluctuations. Severe akinesia, which can cause dysphagia, respiratory complications, and venous stasis in the legs, can benefit from this method of management after major abdominal surgery in a patient with advanced parkinsonism.
Rosin AJ, Devereux D, Eng N, Calne DB. Parkinsonism With 'On-Off' PhenomenaIntravenous Treatment With Levodopa After Major Abdominal Surgery. Arch Neurol. 1979;36(1):32–34. doi:10.1001/archneur.1979.00500370062014