Colon Disease, Gynecologic Disease
Conditions
Keywords
Trendelenburg position, Optic nerve sheath diameter, Colon surgery, Gynecologic surgery
Brief summary
It is difficult to measure the several levels of intracranial pressure during abdominal surgery, and direct monitoring with intracranial devices is often impossible. Measurement of optic nerve sheath diameter (ONSD) via ultrasonography has been developed as an alternative method for evaluating intracranial pressure. Increased intracranial pressure may cause in expanding of the optic nerve sheath and may increase the diameter. Therefore, measuring the diameter of the optic nerve sheath via ultrasonography is considered as a non-invasive, easy-to-apply and reliable method to evaluate intracranial pressure.
Detailed description
The peritoneum is inflated with carbon dioxide (insufflation) and head-down position is performed (Trendelenburg) during laparoscopic colon and gynecologic surgeries. Intracranial pressure (ICP) may be affected by positive intraabdominal pressure due to pneumoperitoneum. The Trendelenburg position (usually at a degree of 25-400) causes increasing in the pressure of cerebrospinal fluid during surgery. Therefore, cerebral edema and an increasing in ICP may occur. It is difficult to measure the several levels of intracranial pressure during abdominal surgery, and direct monitoring with intracranial devices is often impossible. Measurement of optic nerve sheath diameter (ONSD) via ultrasonography has been developed as an alternative method for evaluating intracranial pressure. The optic nerve is an extension of the central nervous system, surrounded by cerebrospinal fluid (CSF) and continues with the nerve sheath. Increased intracranial pressure may cause in expanding of the optic nerve sheath and may increase the diameter. Therefore, measuring the diameter of the optic nerve sheath via ultrasonography is considered as a non-invasive, easy-to-apply and reliable method to evaluate intracranial pressure. In this study, we aimed to evaluate the changes of optic nerve sheath diameter in patients who will undergo laparoscopic colon and gynecologic surgery during trendelenburg position. Our primary goal is to compare the optic nerve sheath diameters via ultrasonography, and our secondary aim is to evaluate the effect of this change on intracranial pressure.
Interventions
OTHEROptic nerve sheath diameter
Pre and post-trendelenburg optic nerve sheath diameter will be measured
Sponsors
Medipol University
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Inclusion criteria
* American Society of Anesthesiologists (ASA) classification I-II * Scheduled for laparoscopic colon and gynecologic surgeries under general anesthesia
Exclusion criteria
* use of beta blocker or diuretic drugs * severe heart failure * diabetes with ocular or neurologic complications * history of cardiac, eye, intracranial, and thoracic surgery * history of hydrocephalus, glocoma, intracranial tumor, cerebrovascular disease
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Optic nerve sheath diameter | Change from baseline optic nerve sheath diameter at 10 mins and 60 mins after trendelenburg. And 10 minutes after the re-neutral position | Pre and post-trendelenburg diameters of optic nerve sheath |
Countries
Turkey (Türkiye)
Outcome results
None listed