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  • Print publication year: 2011
  • Online publication date: May 2011

Case 59 - Ventriculoperitonealshunt

from Section I - Neuroanesthesia

Summary

Neurosurgical procedures are very rarely performed in a straightforward supine position. This chapter presents a case study of a 69-year-old female with a history of renal cell carcinoma developed new back pain and radiculopathy. Resuscitation efforts continued while the wound was packed and the patient was repositioned supine to facilitate external cardiac compressions. The wound continued to bleed during the unsuccessful resuscitation effort. This case was an exposure to the surgical site of bleeding was poorly accessible due to the need to perform cardiopulmonary resuscitation (CPR) in the supine position. The patient will already have a definitive airway and intravenous access established, thereby eliminating potentially the largest drawbacks of prone CPR: the hindrance of airway and intravenous catheter acquisition. Intraoperative scenarios in which the patient is in the prone position, as in cases of spinal surgery, are unique settings for which prone CPR may be well-suited as a resuscitation technique.

References

1. C. Sainte-Rose, J. H. Piatt, D. Renier et al. Mechanical complications in shunts. Pediatr Neurosurg 1991; 17: 2–9.
2. P. Marik, K. Chen, J. Varon et al. Management of increased intracranial pressure: a review for clinicians. J Emerg Med 1999; 17: 711–19.
3. S. Tuli, J. Drake, J. Lawless et al. Risk factors for repeated cerebrospinal shunt failures in pediatric patients with hydrocephalus. J Neurosurg 2000; 92: 31–8.
4. R. K. Hamid, P. Newfield. Pediatric neuroanesthesia. Hydrocephalus. Anesthesiol Clin North America 2001; 19: 207–18.
5. G. Li, S. Dutta. Perioperative management of ventriculoperitoneal shunts during abdominal surgery. Surg Neurol 2008; 70: 492–5.