scholarly journals Optic nerve sheath diameter changes during gynecologic surgery in the Trendelenburg position: comparison of propofol-based total intravenous anesthesia and sevoflurane anesthesia

2019 ◽  
Vol 14 (4) ◽  
pp. 393-400
Author(s):  
Youn Young Lee ◽  
Heeseung Lee ◽  
Hahck Soo Park ◽  
Won Joong Kim ◽  
Hee Jung Baik ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Optic Nerve Sheath Diameter ◽  
Total Intravenous Anesthesia ◽  
Optic Nerve Sheath ◽  
Gynecologic Surgery ◽  
Sevoflurane Anesthesia ◽  
Trendelenburg Position ◽  
Intravenous Anesthesia ◽  
Nerve Sheath

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 Comparison of the Effects of Normocapnia and Mild Hypercapnia on the Optic Nerve Sheath Diameter and Regional Cerebral Oxygen Saturation in Patients Undergoing Gynecological Laparoscopy with Total Intravenous Anesthesia

2021 ◽  
Vol 10 (20) ◽  
pp. 4707
Author(s):  
Chun-Gon Park ◽  
Wol-Seon Jung ◽  
Hee-Yeon Park ◽  
Hye-Won Kim ◽  
Hyun-Jeong Kwak ◽  
...  
Keyword(s):  
Optic Nerve Sheath Diameter ◽  
Total Intravenous Anesthesia ◽  
Intergroup Difference ◽  
Regional Cerebral Oxygen Saturation ◽  
Trendelenburg Position ◽  
Co2 Pneumoperitoneum ◽  
Intravenous Anesthesia ◽  
Nerve Sheath ◽  
Gynecological Laparoscopy ◽  
Group Target

Cerebral hemodynamics may be altered by hypercapnia during a lung-protective ventilation (LPV), CO2 pneumoperitoneum, and Trendelenburg position during general anesthesia. The purpose of this study was to compare the effects of normocapnia and mild hypercapnia on the optic nerve sheath diameter (ONSD), regional cerebral oxygen saturation (rSO2), and intraoperative respiratory mechanics in patients undergoing gynecological laparoscopy under total intravenous anesthesia (TIVA). Sixty patients (aged between 19 and 65 years) scheduled for laparoscopic gynecological surgery in the Trendelenburg position. Patients under propofol/remifentanil total intravenous anesthesia were randomly assigned to either the normocapnia group (target PaCO2 = 35 mmHg, n = 30) or the hypercapnia group (target PaCO2 = 50 mmHg, n = 30). The ONSD, rSO2, and respiratory and hemodynamic parameters were measured at 5 min after anesthetic induction (Tind) in the supine position, and at 10 min and 40 min after pneumoperitoneum (Tpp10 and Tpp40, respectively) in the Trendelenburg position. There was no significant intergroup difference in change over time in the ONSD (p = 0.318). The ONSD increased significantly at Tpp40 when compared to Tind in both normocapnia and hypercapnia groups (p = 0.02 and 0.002, respectively). There was a significant intergroup difference in changes over time in the rSO2 (p < 0.001). The rSO2 decreased significantly in the normocapnia group (p = 0.01), whereas it increased significantly in the hypercapnia group at Tpp40 compared with Tind (p = 0.002). Alveolar dead space was significantly higher in the normocapnia group than in the hypercapnia group at Tpp40 (p = 0.001). In conclusion, mild hypercapnia during the LPV might not aggravate the increase in the ONSD during CO2 pneumoperitoneum in the Trendelenburg position and could improve rSO2 compared to normocapnia in patients undergoing gynecological laparoscopy with TIVA.

scholarly journals Comparison of the effects of normal and low blood pressure regulation on the optic nerve sheath diameter in robot assisted laparoscopic radical prostatectomy

2021 ◽  
Author(s):  
Ji Hoon Park ◽  
Ji Hee Hong ◽  
Ji Seob Kim ◽  
Hyung Jun Kim
Keyword(s):  
Blood Pressure ◽  
Optic Nerve ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Pressure Group ◽  
Robot Assisted ◽  
Trendelenburg Position ◽  
Pressure Groups ◽  
Nerve Sheath ◽  
Low Blood Pressure

Background: Robot-assisted laparoscopic radical prostatectomy is an advanced and popular surgical technique. However, increased intracranial pressure which is caused by CO2 pneumoperitoneum and Trendelenburg position is the main cerebrovascular effect. Measurement of optic nerve sheath diameter using ocular ultrasound is a noninvasive and reliable method for the assessment of intracranial pressure. The primary endpoint of this study was to identify whether low blood pressure regulation has any benefit in attenuating an increase of optic nerve sheath diameter during robot-assisted laparoscopic radical prostatectomy.Methods: Optic nerve sheath diameter and cerebral oxygen saturation were measured at baseline (supine position), one and two hours after pneumoperitoneum and Trendelenburg position respectively, and after return to supine position in normal (n = 27) and low blood pressure groups (n = 24).Results: Mean optic nerve sheath diameter values measured at one and two hours after pneumoperitoneum and Trendelenburg position were significantly increased compared to the baseline value (P < 0.001 in normal blood pressure group; P = 0.003 in low blood pressure group). However, the mean optic nerve sheath diameter and cerebral oxygen saturation measured at any of the time points as well as degrees of change between the two groups did not show any significant changes. The peak values of optic nerve sheath diameter in normal and low blood pressure groups demonstrated 14.9% and 9.2% increases, respectively.Conclusions: Low blood pressure group demonstrated an effect in maintaining an increase of optic nerve sheath diameter less than 10% during CO2 pneumoperitoneum and Trendelenburg position.

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