{"title":"俯卧位全身麻醉期间脑室腹腔分流术故障导致脑积水加重，麻醉后意识恢复延迟：病例报告。","authors":"Yosuke Miyamoto, Takashi Kawasaki, Shingo Nakamura, Naoyuki Hirata","doi":"10.1186/s40981-024-00736-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Dysfunction of ventriculoperitoneal (VP) shunts can lead to decreased levels of consciousness. We report a case of delayed emergence from anesthesia due to the malfunction of a VP shunt during neurosurgery in the prone position.</p><p><strong>Case presentation: </strong>A 75-year-old male with a history of VP shunt for a fourth ventricle obstruction underwent cerebral vascular anastomosis in the prone position. His preoperative level of consciousness was clear. The surgery under general anesthesia was completed without any particular issues. After discontinuation of anesthesia, the patient did not awaken for over an hour. Postoperative CT revealed exacerbated hydrocephalus, likely from VP shunt occlusion. After pumping the reservoir of the VP shunt, the patient regained consciousness. He was extubated and discharged from ICU on the second postoperative day with no neurological issues.</p><p><strong>Conclusion: </strong>For surgical patients with a VP shunt, anesthesia management must consider the risk of shunt malfunction due to patient positioning.</p>","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"10 1","pages":"51"},"PeriodicalIF":0.8000,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11333776/pdf/","citationCount":"0","resultStr":"{\"title\":\"Delayed recovery of consciousness from anesthesia due to exacerbation of hydrocephalus caused by a ventriculoperitoneal shunt malfunction during general anesthesia in the prone position: a case report.\",\"authors\":\"Yosuke Miyamoto, Takashi Kawasaki, Shingo Nakamura, Naoyuki Hirata\",\"doi\":\"10.1186/s40981-024-00736-x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Dysfunction of ventriculoperitoneal (VP) shunts can lead to decreased levels of consciousness. We report a case of delayed emergence from anesthesia due to the malfunction of a VP shunt during neurosurgery in the prone position.</p><p><strong>Case presentation: </strong>A 75-year-old male with a history of VP shunt for a fourth ventricle obstruction underwent cerebral vascular anastomosis in the prone position. His preoperative level of consciousness was clear. The surgery under general anesthesia was completed without any particular issues. After discontinuation of anesthesia, the patient did not awaken for over an hour. Postoperative CT revealed exacerbated hydrocephalus, likely from VP shunt occlusion. After pumping the reservoir of the VP shunt, the patient regained consciousness. He was extubated and discharged from ICU on the second postoperative day with no neurological issues.</p><p><strong>Conclusion: </strong>For surgical patients with a VP shunt, anesthesia management must consider the risk of shunt malfunction due to patient positioning.</p>\",\"PeriodicalId\":14635,\"journal\":{\"name\":\"JA Clinical Reports\",\"volume\":\"10 1\",\"pages\":\"51\"},\"PeriodicalIF\":0.8000,\"publicationDate\":\"2024-08-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11333776/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JA Clinical Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1186/s40981-024-00736-x\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JA Clinical Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s40981-024-00736-x","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
Delayed recovery of consciousness from anesthesia due to exacerbation of hydrocephalus caused by a ventriculoperitoneal shunt malfunction during general anesthesia in the prone position: a case report.
Background: Dysfunction of ventriculoperitoneal (VP) shunts can lead to decreased levels of consciousness. We report a case of delayed emergence from anesthesia due to the malfunction of a VP shunt during neurosurgery in the prone position.
Case presentation: A 75-year-old male with a history of VP shunt for a fourth ventricle obstruction underwent cerebral vascular anastomosis in the prone position. His preoperative level of consciousness was clear. The surgery under general anesthesia was completed without any particular issues. After discontinuation of anesthesia, the patient did not awaken for over an hour. Postoperative CT revealed exacerbated hydrocephalus, likely from VP shunt occlusion. After pumping the reservoir of the VP shunt, the patient regained consciousness. He was extubated and discharged from ICU on the second postoperative day with no neurological issues.
Conclusion: For surgical patients with a VP shunt, anesthesia management must consider the risk of shunt malfunction due to patient positioning.
期刊介绍：
JA Clinical Reports is a companion journal to the Journal of Anesthesia (JA), the official journal of the Japanese Society of Anesthesiologists (JSA). This journal is an open access, peer-reviewed, online journal related to clinical anesthesia practices such as anesthesia management, pain management and intensive care. Case reports are very important articles from the viewpoint of education and the cultivation of scientific thinking in the field of anesthesia. However, submissions of anesthesia research and clinical reports from Japan are notably decreasing in major anesthesia journals. Therefore, the JSA has decided to launch a new journal, JA Clinical Reports, to encourage JSA members, particularly junior Japanese anesthesiologists, to publish papers in English language.
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