Neurological Surgery 脳神経外科48巻3号

2020年03月発行

総説

小児脳神経外科の麻酔管理

著者： 鈴木康之¹

所属機関： ¹国立成育医療研究センター手術・集中治療部

ページ範囲：P.203 - P.211

Ⅰ．はじめに
　乳児や小児の脳神経外科の麻酔・周術期管理には，年齢特徴の生理学・病態生理学を理解し，手術手技や麻酔薬が脳神経にどのように影響するか検討しておくことが重要である．特に小児の中枢神経の構造や生理学的な発達は，出生後に急速に変化する．解剖学的にも新生児・乳児は頭蓋骨の縫合が緩やかで大泉門が開いているため，頭蓋内圧（intracranial pressure：ICP）の上昇に対してコンプライアンスが高い．脳神経疾患は年齢により特異的であり，それぞれの病態の理解が必要となる．また，他疾患の合併などの考慮も重要である．さらに，より非侵襲的な手術手技として内視鏡手術が普及し，麻酔管理の対応も必要である．

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