{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T14:22:12Z","timestamp":1777558932818,"version":"3.51.4"},"reference-count":30,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"<jats:p>The purpose of this technical note was to report that lumboperitoneal shunt (LPS) placement under local anesthesia can be a promising alternative for treating idiopathic normal pressure hydrocephalus (iNPH), particularly in elderly patients who might be reluctant to undergo surgery under general anesthesia. The authors present their experience with 202 cases of LPS placement performed for iNPH under local anesthesia between March 2022 and September 2024. The median operative time was 35 minutes, and the median operating room time was 71 minutes. Procedure-related complications were observed in 6 cases (3.0%), with no major complications specifically associated with local anesthesia. No cases required interruption of surgery due to pain, anxiety, or lack of patient cooperation, indicating that the procedure was well tolerated. This experience suggests that LPS placement under local anesthesia can be a safe and efficient option, even in patients with mild cognitive impairment, providing a viable alternative for those at higher risk of complications from general anesthesia. The authors believe that this technique offers a valuable addition to the surgical options for iNPH, and further study could help standardize this approach for wider clinical use.<\/jats:p>","DOI":"10.3171\/2025.3.jns242345","type":"journal-article","created":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T22:46:14Z","timestamp":1751064374000},"page":"1262-1267","source":"Crossref","is-referenced-by-count":2,"title":["Lumboperitoneal shunt placement under local anesthesia: a technical note from an experience with more than 200 cases"],"prefix":"10.3171","volume":"143","author":[{"given":"Yasuaki","family":"Inoue","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Nadogaya Hospital, Kashiwa, Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryo","family":"Oike","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nadogaya Hospital, Kashiwa, Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Iimori","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nadogaya Hospital, Kashiwa, Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Ihara","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nadogaya Hospital, Kashiwa, Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riku","family":"Ishimaru","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nadogaya Hospital, Kashiwa, Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junia","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nadogaya Hospital, Kashiwa, Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shunsuke","family":"Hatakenaka","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nadogaya Hospital, Kashiwa, Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"5","key":"b1","series-title":"Acta Neurol Scand","first-page":"680","article-title":"Prevalence and development of idiopathic normal pressure hydrocephalus: a 16-year longitudinal study in Japan","volume":"146","author":"Iseki C","year":"2022","unstructured":"Iseki C, Takahashi Y, Adachi M,  Prevalence and development of idiopathic normal pressure hydrocephalus: a 16-year longitudinal study in Japan. Acta Neurol Scand. 2022;146(5):680\u2013689."},{"issue":"6","key":"b2","series-title":"World J Surg","first-page":"1444","article-title":"General anesthesia versus regional anesthesia in the elderly patients undergoing hip fracture surgeries: a systematic review and meta-analysis of randomized clinical trials","volume":"47","author":"Cao MM","year":"2023","unstructured":"Cao MM, Zhang YW, Sheng RW,  General anesthesia versus regional anesthesia in the elderly patients undergoing hip fracture surgeries: a systematic review and meta-analysis of randomized clinical trials. World J Surg. 2023;47(6):1444\u20131456."},{"issue":"4","key":"b3","series-title":"Heart Rhythm","first-page":"522","article-title":"Tumescent local anesthesia versus general anesthesia for subcutaneous implantable cardioverter-defibrillator implantation: a cost-effectiveness analysis","volume":"20","author":"Romero J","year":"2023","unstructured":"Romero J, Rodriguez-Taveras J, Diaz JC,  Tumescent local anesthesia versus general anesthesia for subcutaneous implantable cardioverter-defibrillator implantation: a cost-effectiveness analysis. Heart Rhythm. 2023;20(4):522\u2013529."},{"issue":"2","key":"b4","series-title":"Neurol Med Chir (Tokyo)","first-page":"63","article-title":"Guidelines for management of idiopathic normal pressure hydrocephalus (third edition): endorsed by the Japanese Society of Normal Pressure Hydrocephalus","volume":"61","author":"Nakajima M","year":"2021","unstructured":"Nakajima M, Yamada S, Miyajima M,  Guidelines for management of idiopathic normal pressure hydrocephalus (third edition): endorsed by the Japanese Society of Normal Pressure Hydrocephalus. Neurol Med Chir (Tokyo). 2021;61(2):63\u201397."},{"issue":"7","key":"b5","series-title":"AJNR Am J Neuroradiol","first-page":"1456","article-title":"Lumbar puncture test in normal pressure hydrocephalus: does the volume of CSF removed affect the response to tap?","volume":"38","author":"Thakur SK","year":"2017","unstructured":"Thakur SK, Serulle Y, Miskin NP, Rusinek H, Golomb J, George AE. Lumbar puncture test in normal pressure hydrocephalus: does the volume of CSF removed affect the response to tap? AJNR Am J Neuroradiol. 2017;38(7):1456\u20131460."},{"issue":"2","key":"b6","series-title":"Article in Japanese. No Shinkei Geka","first-page":"348","article-title":"Lumbo-peritoneal shunt for patients with idiopathic normal pressure hydrocephalus: surgical technique","volume":"50","author":"Samejima N","year":"2022","unstructured":"Samejima N, Kuwana N, Watanabe A, Kubota M, Seki Y. Lumbo-peritoneal shunt for patients with idiopathic normal pressure hydrocephalus: surgical technique. Article in Japanese. No Shinkei Geka. 2022;50(2):348\u2013357."},{"issue":"6","key":"b7","series-title":"Lancet Neurol","first-page":"585","article-title":"Lumboperitoneal shunt surgery for idiopathic normal pressure hydrocephalus (SINPHONI-2): an open-label randomised trial","volume":"14","author":"Kazui H","year":"2015","unstructured":"Kazui H, Miyajima M, Mori E, Ishikawa M. Lumboperitoneal shunt surgery for idiopathic normal pressure hydrocephalus (SINPHONI-2): an open-label randomised trial. Lancet Neurol. 2015;14(6):585\u2013594."},{"issue":"4","key":"b8","series-title":"J Neurosurg","first-page":"1024","article-title":"Outcomes and complications of different surgical treatments for idiopathic normal pressure hydrocephalus: a systematic review and meta-analysis","volume":"131","author":"Giordan E","year":"2019","unstructured":"Giordan E, Palandri G, Lanzino G, Murad MH, Elder BD. Outcomes and complications of different surgical treatments for idiopathic normal pressure hydrocephalus: a systematic review and meta-analysis. J Neurosurg. 2019;131(4):1024\u20131036."},{"issue":"7","key":"b9","series-title":"Neurol Med Chir (Tokyo)","first-page":"552","article-title":"Use of blunt scalp hooks for abdominal procedure in lumboperitoneal shunt placement: technical note","volume":"54","author":"Kawahara T","year":"2014","unstructured":"Kawahara T, Higashi T, Tokimura H, Arita K, Atsuchi M, Takasaki K. Use of blunt scalp hooks for abdominal procedure in lumboperitoneal shunt placement: technical note. Neurol Med Chir (Tokyo). 2014;54(7):552\u2013553."},{"issue":"2","key":"b10","series-title":"Technical note. J Neurosurg","first-page":"430","article-title":"Endoscopically aided retroperitoneal placement of a lumboperitoneal shunt","volume":"98","author":"Kubo S","year":"2003","unstructured":"Kubo S, Ueno M, Takimoto H, Karasawa J, Kato A, Yoshimine T. Endoscopically aided retroperitoneal placement of a lumboperitoneal shunt. Technical note. 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Clin Pract. 2022;12(3):449\u2013456."},{"issue":"9","key":"b15","series-title":"Neurol Med Chir (Tokyo)","first-page":"420","article-title":"Lumboperitoneal shunt surgery under spinal anesthesia on idiopathic normal pressure hydrocephalus patients","volume":"63","author":"Goto Y","year":"2023","unstructured":"Goto Y, Inoue T, Shitara S, Oka H, Nozuchi S. Lumboperitoneal shunt surgery under spinal anesthesia on idiopathic normal pressure hydrocephalus patients. Neurol Med Chir (Tokyo). 2023;63(9):420\u2013425."},{"issue":"5","key":"b1","series-title":"Acta Neurol Scand","first-page":"680","article-title":"Prevalence and development of idiopathic normal pressure hydrocephalus: a 16-year longitudinal study in Japan","volume":"146","author":"Iseki C","year":"2022","unstructured":"Iseki C, Takahashi Y, Adachi M,  Prevalence and development of idiopathic normal pressure hydrocephalus: a 16-year longitudinal study in Japan. 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J Neurosurg. 2003;98(2):430\u2013433."},{"issue":"3","key":"b11","series-title":"J Neurosurg","first-page":"618","article-title":"Lumboperitoneal shunt placement using computed tomography and fluoroscopy in conscious patients","volume":"111","author":"Nakajima M","year":"2009","unstructured":"Nakajima M, Bando K, Miyajima M, Arai H. Lumboperitoneal shunt placement using computed tomography and fluoroscopy in conscious patients. J Neurosurg. 2009;111(3):618\u2013622."},{"key":"b12","series-title":"Front Public Health","first-page":"1362461","article-title":"Comparison of regional vs. general anesthesia on the risk of dementia: a systematic review and meta-analysis","volume":"12","author":"Chen IW","year":"2024","unstructured":"Chen IW, Sun CK, Chen JY,  Comparison of regional vs. general anesthesia on the risk of dementia: a systematic review and meta-analysis. Front Public Health. 2024;12:1362461."},{"issue":"3","key":"b13","series-title":"Article in French. 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