The effect of head positioning on intraoperative optic nerve sheath diameter and postoperative cognitive function of patients undergoing thyroidectomy

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Hyperextension of the neck is associated with increased postoperative pain and some series complication such as carotid and vertebral artery occlusion which may lead to postoperative cognitive impairment.In the current study, our primary hypothesis is that patients positioned with a shoulder roll will have lower MoCA scores at the postoperative 6th hour than the patients positioned without a shoulder roll. Our secondary hypothesis is that optic nerve sheath diameter (ONSD) which is accepted as a well indicator of changes in ICP, will be greater in the shoulder roll group. Another secondary hypothesis is that the degree of neck extension will be greater in shoulder roll group.In the shoulder roll group (Group 1), patients will lie in supine position with arms tucked and a standard shoulder roll will be placed behind the shoulders of patients to extend the neck. Then head of the operation table will be raised up to 30 degrees from the horizontal plane. In the second group (Group 2), patients will be placed in the same position and the neck will be extended without a shoulder roll.