フォンタン術後患者の非心臓手術における麻酔科管理の徹底―JCHO中京病院での情報共有システム導入前後の変化―

The Anesthetic Management of Post-Fontan Patients Undergoing Non-Cardiac Surgery：The Impact of an Information-Sharing System at JCHO Chukyo Hospital

要旨

　フォンタン術後患者に対する非心臓手術が増加するなか，麻酔科管理外での手術も増加が予想される。しかし，外科系医師にとってフォンタン循環は特殊な病態で，連携や情報共有の面で課題が残り，適切な周術期管理が困難となることがある。そこで，当施設麻酔科はフォンタン術後患者の把握と情報共有を強化し，全症例麻酔科管理下で手術を実施する体制を確立した。

　The role of anesthesiologists in the performance of non-cardiac surgeries in post-Fontan patients is becoming increasingly critical as these surgeries become more common. The frequency of surgeries performed outside of dedicated anesthesia care settings is expected to rise, and Fontan physiology remains a unique challenge for many surgical teams. This necessitates enhanced collaboration and precise information-sharing to ensure optimal patient outcomes. At our institution, the Department of Anesthesiology has proactively developed a protocol for the identification and management of post-Fontan patients, ensuring that all procedures are conducted under anesthesiology oversight. This approach has allowed for safer perioperative management across a spectrum of procedures, from minor interventions involving local anesthesia to complex, highly invasive surgeries.