Evaluation of the effect of trendelenburg position duration on intracranial pressure in laparoscopic hysterectomies using ultrasonographic optic nerve sheath diameter measurements.
BMC Anesthesiol
; 24(1): 238, 2024 Jul 15.
Article
en En
| MEDLINE
| ID: mdl-39010013
ABSTRACT
BACKGROUND:
During laparoscopic surgery, pneumoperitoneum and Trendelenburg positioning applied to provide better surgical vision can cause many physiological changes as well as an increase in intracranial pressure. However, it has been reported that cerebral autoregulation prevents cerebral edema by regulating this pressure increase. This study aimed to investigate whether the duration of the Trendelenburg position had an effect on the increase in intracranial pressure using ultrasonographic optic nerve sheath diameter (ONSD) measurements.METHODS:
The near infrared spectrometry monitoring of patients undergoing laparoscopic hysterectomy was performed while awake (T0); at the fifth minute after intubation (T1); at the 30th minute (T2), 60th minute (T3), 75th minute (T4), and 90th minute (T5) after placement in the Trendelenburg position; and at the fifth minute after placement in the neutral position (T6).RESULTS:
The study included 25 patients. The measured ONSD values were as follows T0 right/left, 4.18±0.32/4.18±0.33; T1, 4.75±0.26/4.75±0.25; T2, 5.08±0.19/5.08±0.19; T3, 5.26±0.15/5.26±0.15; T4, 5.36±0.11/5.37±0.12; T5, 5.45±0.09/5.48±0.11; and T6, 4.9±0.24/4.89±0.22 ( p < 0.05 compared with T0). ). No statistical difference was detected in all measurements in terms of MAP, HR and ETCO2 values compared to the T0 value (p > 0.05).CONCLUSIONS:
It was determined that as the Trendelenburg position duration increased, the ONSD values ââincreased. This suggests that as the duration of Trendelenburg positioning and pneumoperitoneum increases, the sustainability of the mechanisms that balance the increase in intracranial pressure becomes insufficient. TRIAL REGISTRATION This study was registered at Clinical Trials.gov on 21/09/2023 (registration number NCT06048900).Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Nervio Óptico
/
Presión Intracraneal
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Ultrasonografía
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Laparoscopía
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Inclinación de Cabeza
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Histerectomía
Límite:
Adult
/
Female
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Humans
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Middle aged
Idioma:
En
Revista:
BMC Anesthesiol
/
BMC anesthesiol. (Online)
/
BMC anesthesiology (Online)
Año:
2024
Tipo del documento:
Article