Anesthetic management of a patient undergoing abdominal surgery with bilateral ventricular peritoneal shunt in situ

Ain-Shams Journal of Anesthesiology - Tập 13 - Trang 1-4 - 2021
Renu Bala1, Priyanka Bansal1, Srishti Malhan1, Himani Mittal1
1Department of Anaesthesiology, Pt. B.D. Sharma UHSR, Rohtak, India

Tóm tắt

Ventriculoperitoneal (VP) shunts are commonly performed procedures for a variety of disorders and are mostly long standing. These patients when present for non-neurological surgeries like gastrointestinal, urology, or caesarean section, there are several concerns like difficult abdominal surgery due to peritoneal adhesions, chances of shunt infection with potential retrograde infective meningoencephalitis, and ventriculitis or shunt failure with recurrent hydrocephalus. A 35-year-old male, known case of third ventricular tumour with functional left-sided ventricular peritoneal shunt was scheduled to undergo cholecystectomy for gall bladder stone. Intraoperatively optic nerve sheath diameter was measured as an indicator of raised intracranial pressure. Intraoperative was uneventful. Efforts were taken to prevent rise in intracranial pressure perioperatively. Patient was discharged on third postoperative day. A vigilant perioperative care along with adequate team work go a long way in achieving success in patients of ventriculoperitoneal shunts presenting for non-neurological surgeries.

Tài liệu tham khảo

Hammill CW, Au T, Wong LL (2010) Laparoscopic cholecystectomy in a patient with a ventriculoperitoneal shunt. Hawaii Med J 69(4):103–104 PMID: 20481236; PMCID: PMC3111663 Li G, Dutta S (2008) Perioperative management of ventriculoperitoneal shunts during abdominal surgery. Surg Neurol 70(5):492–497. https://doi.org/10.1016/j.surneu.2007.08.050 Lykoudis PM, Nastos C, Dellaportas D, Vezakis A, Ayiomamitis GD, Papaconstantinou I, Theodosopoulos T, Polydorou A, Polymeneas G (2017) Laparoscopic cholecystectomy in patients with ventriculoperitoneal shunts: a case series. Hell J Surg 89(3-4):163–165. https://doi.org/10.1007/s13126-017-0405-3 Raffiz M, Abdullah JM (2016) Optic nerve sheath diameter measurement: a means of detecting raised ICP in adult traumatic and non-traumatic neurosurgical patients. Am J Emerg Med 35(1):150–153. https://doi.org/10.1016/j.ajem.2016.09.044 Staikou C, Tsaroucha A, Mani A, Fassoulaki A (2012) Transcranial Doppler monitoring of middle cerebral flow velocity in a patient with a ventriculoperitoneal shunt undergoing laparoscopy. J Clin Monit Comput 26(6):487–489. https://doi.org/10.1007/s10877-012-9380-y Wang YM, Liu YC, Ye XD, Chia YY, Liu K (2003) Anesthetic management of laparoscopic surgery in a patient with a ventriculoperitoneal shunt. Acta Anaesthesiol Sin 41(2):85–88 PMID: 12934423 Whitney PS, Sturgess J (2016) Anesthetic considerations for patients with neurosurgical implants. BJA Educ 16(7):230–235. https://doi.org/10.1093/bjaed/mkv049