具有腦室腹腔引流管的病患在接受腹腔鏡手術時麻醉方面的考量－－病例報告

Anesthetic Management of Laparoscopic Surgery in a Patient with a Ventriculoperitoneal Shunt

由於腹腔鏡手術愈來愈受歡迎，所以具有腦室腹腔引流管的病患接受腹腔鏡手術的情形預期會愈來愈多。關於這類病人接受腹腔鏡手術時麻醉的方法及安全並未真正的被建立過，手術中腦壓升高是可能發生的。我們報告一個病例並探討這類病人接受腹腔鏡手術時麻醉方面的考量。

With advanced knowledge of management of hydrocephalus, patients with ventriculoperitoneal shunts are expected to enjoy a longer lifetime. Developments in both instrumentations and surgical techniques have led to increasing popularity of laparoscopic surgery in many surgical subspecialties. Therefore, it is not a surprising event that a patient with a ventriculoperitoneal shunt is scheduled for a laparoscopic surgery under anesthesia. Until now, there is no uniformized protocol for anesthetic management of a patient with a ventriculoperitoneal shunt undergoing laparoscopic surgery. Increased intracranial pressure may occur intraoperatively and be a major concern. We report here our experience in anesthetic management of such a patient and discuss the anesthetic considerations and the potential complications.