Upper airway obstruction during extubation after general anesthesia, in a patient with Parkinson disease: A case report

RATIONALE: Parkinson disease (PD) is a chronic neurodegenerative condition often suffered by the elderly. Upper airway obstruction, though rare in patients with PD, can be life threatening and is associated with vocal cord paralysis, laryngeal spasm, and dystonia of jaw and neck muscles. PATIENT CONCERNS: We describe a life-threatening upper airway obstruction caused by bilateral vocal cord paralysis, in an elderly man with PD, during extubation after general anesthesia. DIAGNOSES: Based on clinical presentation and visual laryngoscopy, the patient was diagnosed with laryngeal spasm and bilateral vocal cord paralysis after extubation. INTERVENTIONS: Re-intubation was carried out and dopamine hydrazine tablets were administered via a nasal feeding tube. OUTCOMES: After re-intubation and further treatment, the endotracheal tube was successfully removed and no symptoms of respiratory distress were observed. LESSONS: Patients with PD may be at a risk of life-threatening upper airway obstruction after extubation, which should be prevented systematically.