scholarly journals Propofol Affects Optic Nerve Sheath Diameter less than Sevoflurane during Robotic Surgery in the Steep Trendelenburg Position

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Yanghyun Kim ◽  
Seomun Choi ◽  
Sungwoo Kang ◽  
Boram Park
Keyword(s):  
Optic Nerve ◽  
Demographic Data ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Ischemic Optic Neuropathy ◽  
Trendelenburg Position ◽  
Nerve Sheath ◽  
Steep Trendelenburg Position ◽  
The Mean ◽  
End Tidal

Background. Robot-assisted laparoscopic radical prostatectomy (RLRP) can increase intracranial pressure (ICP) related to a change in position. Increasing ICP may result in various ocular complications, which are rare but serious, such as a corneal abrasion and ischemic optic neuropathy. We performed a prospective observational trial using ultrasonographic measurements to compare optic nerve sheath diameter (ONSD) related to ICP between patients who received either propofol or sevoflurane and underwent RLRP. Methods. Thirty-two male patients scheduled to undergo RLRP were assigned into groups according to the anesthetic agent used (group P: propofol, n = 16; group S: sevoflurane, n = 16). ONSD, end-tidal partial pressure of CO2, and blood pressure were measured 10 min after induction of anesthesia (T0), 30 min (T1), 60 min (T2), and 90 min after changing to the steep Trendelenburg position and introducing a pneumoperitoneum (T3) and 10 min after returning the patient’s position to supine (T4) during surgery. Results. No significant differences were observed in the demographic data of the patients, surgery time, or intraoperative variables, including hemodynamic and respiratory variables, at any of the time points. The mean right ONSDs in the propofol and sevoflurane groups were 37.3 and 40.1 mm at 30 min (p=0.003), respectively. The mean left ONSDs were 38.4 and 40.8 mm at 30 min (p=0.021) after changing to the Trendelenburg position. The ONSDs between the two groups were significantly different during surgery. Conclusions. ONSD increased more in the sevoflurane group than in the propofol group during RLRP. Intravenous anesthetics could alleviate the increase in ICP during RLRP.

scholarly journals Prospective Study: Optic Nerve Sheath ‎Diameter in Prediction of Fluid ‎Responsiveness in Sepsis Patients

2021 ◽  
pp. 244-253
Author(s):  
Hadeel Ibraheim Elsagheir ◽  
Abd Elaziz Hamed El Badawy ◽  
Reda Sobhi Salama Abd Alrahman ◽  
Mohamed Samir Abd El Ghafar
Keyword(s):  
Optic Nerve ◽  
Fluid Responsiveness ◽  
Demographic Data ◽  
Optic Nerve Sheath Diameter ◽  
Mean Value ◽  
Optic Nerve Sheath ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Nerve Sheath ◽  
The Mean

Background: Sepsis is a life-threatening disease caused by the body's reaction to infection, which results in tissue destruction, organ failure, and death. Sepsis affects at least 30 million people worldwide each year, with 6 million people dying as a result. The goal of the research was to see whether the measurement of the Optic Nerve Sheath Diameter (ONSD) could be used to predict fluid responsiveness in hemodynamically unstable individuals.‎ Patients and Methods: This prospective observational (cohort) study was conducted at Tanta ‎University Hospitals in the Surgical Intensive Care Unit for 6 months at least ‎after approval from institutional ethics committee‎. Results: Demographic data (sex, illiteracy, height, BMI) in our patients of the study there ‎were 34 (81%) male, 8 (19%) female, the age was average from 50.33 (±8.63 ‎SD) with range (25-65), 9 (21.4%) illiterate, 10 (23.8%) primary, 18 (42.9%) ‎secondary, 5 (11.9%) university, the mean value of weight 80.29 (±9.45 SD) ‎with range (60.7-98.8), the mean value of height 170.57 (±7.24 SD) with ‎range (157-182), the mean value of BMI 27.54 (±2.19 SD) with range (24.3-‎‎32).‎ Conclusion: In patients with sepsis, ocular ultrasonography appears to be a non-invasive and simple-to-learn technique for assessing overall fluid status. It may be particularly effective in finding those septic individuals who should avoid further fluid intake since it could cause pulmonary edema or other fluid-related problems.

scholarly journals Effects of Increased Optic Nerve Sheath Diameter on Inadequate Emergence from Anesthesia in Patients Undergoing Robot-Assisted Laparoscopic Prostatectomy: A Prospective Observational Study

Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2260
Author(s):  
Yu Jeong Bang ◽  
Heejoon Jeong ◽  
Burn Young Heo ◽  
Byung Seop Shin ◽  
Woo Seog Sim ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Robot Assisted ◽  
Trendelenburg Position ◽  
Laparoscopic Prostatectomy ◽  
Nerve Sheath ◽  
Neurologic Deficits ◽  
Steep Trendelenburg Position

(1) Background: Robot-assisted laparoscopic prostatectomy (RALP) is preferred over open prostatectomy because it offers superior surgical outcomes and better postoperative recovery. The steep Trendelenburg position and pneumoperitoneum required in Robot-assisted laparoscopic prostatectomy, however, increase intracranial pressure (ICP). The present study aimed to evaluate the effects of elevated ICP on the quality of emergence from anesthesia. (2) Methods: Sixty-seven patients undergoing RALP were enrolled. We measured optic nerve sheath diameter at four timepoints during surgery. Primary outcome was inadequate emergence in the operating room (OR). Secondary outcomes were postoperative neurologic deficits of dizziness, headache, delirium, cognitive dysfunction, and postoperative nausea and vomiting (PONV). (3) Results: A total of 69 patients were screened for eligibility and 67 patients completed the study and were included in the final analysis. After establishing pneumoperitoneum with the Trendelenburg position, ONSD increased compared to baseline by 11.4%. Of the 67 patients, 36 patients showed an increase of 10% or more in optic nerve sheath diameter (ONSD). Patients with ΔONSD ≥ 10% experienced more inadequate emergence in the OR than those with ΔONSD < 10% (47.2% vs. 12.9%, p = 0.003). However, other variables related to the quality of emergence from anesthesia did not different significantly between groups. Similarly, neurologic deficits, and PONV during postoperative day 3 showed no significant differences. (4) Conclusions: ICP elevation detected by ultrasonographic ONSD measurement was associated with a transient, inadequate emergence from anesthesia.

Are ultrasonography measurements of optic nerve sheath diameter an alternative to funduscopy in children with syndromic craniosynostosis?

2011 ◽  
Vol 8 (3) ◽  
pp. 329-334 ◽  
Author(s):  
Caroline Driessen ◽  
Natalja Bannink ◽  
Maarten Lequin ◽  
Marie-Lise C. van Veelen ◽  
Nicole C. Naus ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Predictive Values ◽  
Syndromic Craniosynostosis ◽  
Nerve Sheath ◽  
Age Related ◽  
The Mean ◽  
A Prospective Study ◽  
Ct Measurement

Object Children with syndromic or complex craniosynostosis are evaluated for increased intracranial pressure (ICP) using funduscopy to detect papilledema. However, papilledema is a late sign of increased ICP. Because papilledema might be preceded by an increase in optic nerve sheath (ONS) diameter, the authors conducted a prospective study to establish the validity and applicability of measuring the ONS using ultrasonography. Methods From January 2007 to December 2009, 175 bilateral ultrasonography ONS measurements were performed in 128 patients with syndromic or complex craniosynostosis during the daytime. The measurements were correlated with ONS diameter assessed on CT and simultaneous funduscopy, when available. Furthermore, results were compared by using thresholds for ONS diameters on ultrasonography that are available in the literature. Results The mean ONS diameter on ultrasonography was 3.1 ± 0.5 mm. The CT measurement was significantly correlated with the ultrasonography measurement (r = 0.41, p < 0.001). The mean ONS diameter in 38 eyes with papilledema was 3.3 ± 0.5 mm, compared with 3.1 ± 0.5 mm in the eyes of patients without papilledema (p = 0.039). Relative to the age-related thresholds, the ONS diameter was too large in 11 eyes (3%), particularly in patients with Crouzon syndrome. Compared with funduscopy, ultrasonography sensitivity was 11%, specificity was 97%, and positive and negative predictive values were 40% and 86%, respectively. Conclusions Ultrasonography is a valid and easy way of quantifying the ONS. Although the ONS diameter is larger in children with papilledema, it cannot be used as a daytime screening tool instead of funduscopy. The ONS diameter is possibly a more real-time indicator of ICP.

scholarly journals To observe the changes of optic nerve sheath diameter following the use of total intravenous anaesthesia with propofol or inhalational anaesthesia with desflurane during laparoscopic surgeries

2021 ◽  
Vol 8 (4) ◽  
pp. 515-520
Author(s):  
Pratikkumar Patel ◽  
Vijay Mathur ◽  
Shruti Singhal ◽  
Durga Jethava
Keyword(s):  
Laparoscopic Surgery ◽  
Optic Nerve ◽  
Intracranial Pressure ◽  
Optic Nerve Sheath Diameter ◽  
Total Intravenous Anaesthesia ◽  
Trendelenburg Position ◽  
Intravenous Anaesthesia ◽  
Nerve Sheath ◽  
Inhalational Anaesthesia ◽  
The Mean

Optic nerve sheath diameter measurement is a simple, non-invasive and yet accurate intracranial pressure (ICP) assessment technique during laparoscopic surgery. The pneumoperitoneum induced by insufflating carbon-dioxide and steep angle of trendelenburg position is associated with physiological changes resulting in increased ICP during laparoscopic surgery. We aimed to observe the changes of ONSD (surrogate marker of ICP) following the use of total intravenous anaesthesia in comparison to desflurane during laparoscopic surgery.Patients scheduled for elective laparoscopic surgery were randomly assigned to the TIVA or DES group in this randomized study. Ultrasonographic measurements of ONSD were conducted before administration of anaesthesia (T0), 10 mins, 30 mins, 1 hr after the trendelenburg position (T1,T2,T3), 5mins after resuming the supine position (T4) and at post-anaesthetic care unit (T5). The primary outcome measure was the comparison of the mean ONSD of both the eyes of the patients of both the groups that is TIVA versus DES (inhalational anaesthetic) group.A total of 60 patients were analysed in our study. The mean ONSD value at T1, T2, T3 and T4 (for right eye p=0.002,0.001,&#60;0.01,0.03 respectively and for left eye p=0.004,&#60;0.01,&#60;0.01,0.02 respectively) were significantly lower for patients in TIVA group as compared with those in DES group.Our result suggests that TIVA may be a better option than inhalational anaesthesia to prevent rise in intracranial pressure in patients undergoing laparoscopic surgery and preventing devastating complications caused by raised intracranial pressure in succeptible patients.

Ultrasound Nomograms of the Fetal Optic Nerve Sheath Diameter

2018 ◽  
Vol 40 (04) ◽  
pp. 476-480 ◽  
Author(s):  
Karina Krajden Haratz ◽  
Yaakov Melcer ◽  
Zvi Leibovitz ◽  
Hagit Feit ◽  
Tally Lerman-Sagie ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Optic Nerve Sheath Diameter ◽  
Quadratic Equation ◽  
Optic Nerve Sheath ◽  
Specific Reference ◽  
Intraobserver Variability ◽  
Cross Sectional ◽  
Mean Values ◽  
Nerve Sheath ◽  
The Mean

Abstract Objective To construct prenatal age-specific reference intervals for sonographic measurements of the optic nerve sheath diameter (ONSD) during gestation in normal fetuses. Materials and Methods Prospective cross-sectional study of fetuses assessed in antenatal ultrasound units between 2010 and 2014. The examination was based on a technique for the sonographic assessment of ONSD previously published by our group. The mean values and SDs of the ONSD were modeled as a function of the gestational week by curve estimation analysis based on the highest adjusted R2 coefficient. Repeatability tests were performed to assess intraobserver variability and interobserver agreement. Results During the study period 364 healthy fetuses were enrolled. The mean values for the ONSD varied from 0.6 mm at 15–16 weeks to 2.8 mm at 37–38 weeks. The ONSD grows in a linear fashion throughout gestation, with a quadratic equation providing an optimal fit to the data (adjusted R2 = 0.957). Conclusion Sonographic age-specific references for the fetal ONSD are presented. This data may assist in the decision-making process in fetuses with a suspected increase in intracranial pressure, or anomalies affecting the development of optic stalks, such as optic hypoplasia and septo-optic dysplasia.

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