Minim Invasive Neurosurg 2004; 47(2): 90-92
DOI: 10.1055/s-2003-812536
Original Article
© Georg Thieme Verlag Stuttgart · New York

A Simplified Endoscopic Third Ventriculostomy Under Local Anesthesia

P.  L.  Longatti1 , G.  Barzoi2 , F.  Paccagnella3 , U.  Corbanese4 , A.  Fiorindi1 , A.  Carteri1
  • 1Department of Neurosurgery, Regional Hospital, Treviso, Italy
  • 2Department of Anesthesia and Intensive Care, University Campus Bio-Medico, Rome, Italy
  • 32nd Department of Anesthesia and Intensive Care, Regional Hospital, Treviso, Italy
  • 4Department of Anesthesia and Intensive Care, Ospedale S. Maria dei Battuti, Conegliano, Italy
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Publikationsverlauf

Publikationsdatum:
16. Juli 2004 (online)

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Zusammenfassung

Abstract

The aim of this study is the analysis of our experience with awake endoscopic third ventriculostomy (ETVS) in hydrocephalic patients. From September 1994 to December 2001, 24 neuroendoscopic procedures were performed under local anesthesia. Local infiltration was administered using a bupivacaine and lidocaine mixture. Analgesics were titrated to the effect. A free-hand technique with a flexible endoscope was adopted in 24 patients with primitive and secondary (neoplastic) hydrocephalus. ETVS was performed successfully in all cases. No procedure needed to be discontinued due to seizures, bleeding or agitation. Dural incision/coagulation and Fogarty dilatation proved to be the most painful maneuvers requiring, sometimes, supplemental analgesic administration. No intraoperative complications were observed; however, two asymptomatic trajectory hematomas were incidentally discovered two and three days after the operation, respectively. Awake ETVS is a valuable alternative procedure that can be adopted in adult cooperative patients, provided that the procedure is done in an essential and fast way with the free-hand technique, by means of a flexible endoscope, and with the assistance of an anesthesiologist.

References

P. L. Longatti

Department of Neurosurgery · Ca' Foncello Regional Hospital · P. le Ospedale

31100 Treviso

Italy

Telefon: + 39-0422-322506

Fax: + 39-0422-322523

eMail: plongatti@ulss.tv.it