Intracranial Pressure, Mechanical Ventilation, Optic Nerve Sheath Diameter, Positive End-expiratory Pressure (PEEP)
Conditions
Brief summary
This prospective interventional study will evaluate the effects of applying positive end-expiratory pressure (PEEP) at 10 cmH₂O on optic nerve sheath diameter (ONSD) in patients undergoing elective laparoscopic cholecystectomy under general anesthesia. A total of approximately 40 adult patients (ASA physical status I-II) will be included following informed consent. ONSD will be measured using a high-frequency linear ultrasound probe at three predefined intraoperative time points: (T0) 10 minutes after initiation of mechanical ventilation, (T1) 10 minutes after pneumoperitoneum creation, and (T2) 30 minutes after pneumoperitoneum creation. Dynamic lung compliance, peak airway pressure (Ppeak), end-tidal CO₂ (EtCO₂), heart rate, mean arterial pressure, and SpO₂ will also be recorded. The aim is to assess whether the application of PEEP influences intracranial pressure indicators, particularly ONSD, during laparoscopic procedures. The study may provide valuable insights into the neurophysiological effects of intra-abdominal pressure and mechanical ventilation strategies in surgical patients.
Interventions
Application of 10 cmH₂O PEEP during mechanical ventilation after pneumoperitoneum creation in patients undergoing laparoscopic cholecystectomy.
Sponsors
Nigde Omer Halisdemir University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
\- Adult patients (age ≥ 18 years) American Society of Anesthesiologists (ASA) physical status I-III Scheduled for elective laparoscopic cholecystectomy under general anesthesia Signed informed consent
Exclusion criteria
* resence of acute or chronic eye disease Uncontrolled hypertension Asthma or known chronic pulmonary disease Any neurological disorders Body mass index (BMI) \> 35 kg/m² Use of medications known to affect intracranial pressure Refusal to participate after signing informed consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Optic Nerve Sheath Diameter (ONSD) | Intraoperative; T0, T1, T2 | ONSD will be measured via ultrasound at 3 time points during surgery. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Peak Airway Pressure (Ppeak) | Intraoperative measurement at T0, T1, and T2 | Peak airway pressure will be measured using the ventilator settings at three predefined intraoperative time points to evaluate respiratory mechanics during PEEP application. |
| Change in Dynamic Lung Compliance | Intraoperative measurement at T0, T1, and T2 | Dynamic lung compliance will be calculated using the formula: Tidal Volume / (Ppeak - PEEP) and measured at three intraoperative time points. |
| Change in End-Tidal Carbon Dioxide (EtCO₂) | Intraoperative measurement at T0, T1, and T2 | End-tidal CO₂ levels will be recorded intraoperatively to monitor changes in ventilation efficiency during surgery. |
| Changes in Heart Rate (HR) and Mean Arterial Pressure (MAP) Time Frame | Intraoperative measurement at T0, T1, and T2 | Heart rate and mean arterial pressure will be recorded at predefined time points to assess hemodynamic stability during surgery. |
| Peripheral Oxygen Saturation (SpO₂) | Intraoperative continuous monitoring and recorded at T0, T1, and T2 | Peripheral oxygen saturation will be monitored continuously and recorded at specified intraoperative time points. |
Countries
Turkey (Türkiye)
Outcome results
None listed