Effects of sevoflurane and propofol on the optic nerve sheath diameter in patients undergoing laparoscopic gynecological surgery: A Randomized controlled clinical studies

Abstract Background The results of studies on changes in intracranial pressure in patients undergoing laparoscopic surgery are inconsistent. Meanwhile, previous neurosurgery studies have suggested that propofol and sevoflurane have inconsistent effects on cerebral blood flow and cerebrovascular self-regulation. The purpose of this study is to compare changes in the optic nerve sheath diameter in patients undergoing laparoscopic gynecological surgery under anesthetic maintenance with propofol versus sevoflurane. Methods This study included 110 patients undergoing laparoscopic gynecological surgery with an estimated operative time of more than 2 hours under general anesthesia. The study was a randomized controlled study. The optic nerve sheath diameter（ONSD）at various time points was measured by ultrasound, including when the patients entered the operating room (Tawake), after successful anesthesia induction and endotracheal intubation (Tinduction), when the body position was adjusted to the Trendelenburg position and the CO2 pneumoperitoneum pressure reached 14 mmHg, which was recorded as T0. Then, measurements were conducted every 15 minutes for the first 1 hour and then once every hour until the end of the surgery（T15,T30,T45 ,T1h ,T2h…）, after the end of surgery and the tracheal tube was removed (Tend), and before the patients were transferred to the ward (Tpacu).Results A significant difference in optic nerve sheath diameter was found between two groups at T15, T30, T45 (4.64±0.48mm and 4.50±0.29mm, respectively, p=0.031;4.77±0.45mm and 4.62±0.28mm, respectively, p=0.036;4.84±0.46mm and 4.65±0.30mm, respectively, p=0.012), while there was no significant difference at Tawake and other time points. Conclusion During laparoscopic gynecological surgery lasting more than 2 hours, the optic nerve sheath diameter was slightly larger in the propofol group than that in the sevoflurane group in the first 45 minutes. No significant difference was observed between the two groups 1 hour after surgery. Trial registration clinicaltrials.gov，NCT03498235. Retrospectively registered 1 March2018,https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0007UMM&selectaction=Edit&uid=U00040C5&ts=39&cx=c7i8icThe manuscript adheres to CONSORT guidelines.

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Effects of sevoflurane and propofol on the optic nerve sheath diameter in patients undergoing laparoscopic gynecological surgery: a randomized controlled clinical studies

BMC Anesthesiology ◽

10.1186/s12871-021-01243-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Weilian Geng ◽

Changxing Chen ◽

Xingfeng Sun ◽

Shaoqiang Huang

Keyword(s):

Optic Nerve ◽

Optic Nerve Sheath Diameter ◽

Optic Nerve Sheath ◽

Controlled Study ◽

Anesthesia Induction ◽

Gynecological Surgery ◽

Time Points ◽

Randomized Controlled ◽

Nerve Sheath ◽

Significant Difference

Abstract Background The results of studies on changes in intracranial pressure in patients undergoing laparoscopic surgery are inconsistent. Meanwhile, previous neurosurgery studies have suggested that propofol and sevoflurane have inconsistent effects on cerebral blood flow and cerebrovascular self-regulation. The purpose of this study is to compare changes in the optic nerve sheath diameter in patients undergoing laparoscopic gynecological surgery under anesthetic maintenance with propofol versus sevoflurane. Methods This study included 110 patients undergoing laparoscopic gynecological surgery with an estimated operative time of more than 2 h under general anesthesia. The study was a randomized controlled study. The optic nerve sheath diameter (ONSD) at various time points was measured by ultrasound, including when the patients entered the operating room (Tawake), after successful anesthesia induction and endotracheal intubation (Tinduction), when the body position was adjusted to the Trendelenburg position and the CO2 pneumoperitoneum pressure reached 14 mmHg, which was recorded as T0. Then, measurements were conducted every 15 min for the first 1 h and then once every hour until the end of the surgery (T15, T30, T45, T1h, T2h …), after the end of surgery and the tracheal tube was removed (Tend), and before the patients were transferred to the ward (Tpacu). Results A significant difference in optic nerve sheath diameter was found between two groups at T15, T30, T45 (4.64 ± 0.48 mm and 4.50 ± 0.29 mm, respectively, p = 0.031;4.77 ± 0.45 mm and 4.62 ± 0.28 mm, respectively, p = 0.036;4.84 ± 0.46 mm and 4.65 ± 0.30 mm, respectively, p = 0.012), while there was no significant difference at Tawake and other time points. Conclusion During laparoscopic gynecological surgery lasting more than 2 h, the optic nerve sheath diameter was slightly larger in the propofol group than that in the sevoflurane group in the first 45 min. No significant difference was observed between the two groups 1 h after surgery. Trial registration clinicaltrials.gov, NCT03498235. Retrospectively registered 1 March 2018. The manuscript adheres to CONSORT guidelines.

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Effects of sevoflurane and propofol on the optic nerve sheath diameter in patients undergoing laparoscopic gynecological surgery: A Randomized controlled clinical studies

10.21203/rs.3.rs-52905/v2 ◽

2020 ◽

Author(s):

Weilian Geng ◽

Changxing Chen ◽

Xingfeng Sun ◽

Shaoqiang Huang

Keyword(s):

Optic Nerve ◽

Optic Nerve Sheath Diameter ◽

Optic Nerve Sheath ◽

Controlled Study ◽

Anesthesia Induction ◽

Gynecological Surgery ◽

Time Points ◽

Randomized Controlled ◽

Nerve Sheath ◽

Significant Difference

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Effects of Sevoflurane and Propofol on the Optic Nerve Sheath Diameter in Patients Undergoing Laparoscopic Gynecological Surgery: A Randomized Controlled Clinical Studies

10.21203/rs.3.rs-52905/v1 ◽

2020 ◽

Author(s):

Weilian Geng ◽

Changxing Chen ◽

Xingfeng Sun ◽

Shaoqiang Huang

Keyword(s):

Optic Nerve ◽

Optic Nerve Sheath Diameter ◽

Optic Nerve Sheath ◽

Controlled Study ◽

Gynecological Surgery ◽

Trendelenburg Position ◽

Time Points ◽

Randomized Controlled ◽

Nerve Sheath ◽

Significant Difference

Abstract Background The results of studies on changes in intracranial pressure in patients undergoing laparoscopic surgery are inconsistent. Meanwhile, previous neurosurgery studies have suggested that propofol and sevoflurane have inconsistent effects on cerebral blood flow and cerebrovascular self-regulation. The purpose of this study is to compare changes in the optic nerve sheath diameter in patients undergoing laparoscopic gynecological surgery under anesthetic maintenance with propofol versus sevoflurane. Methods This study included 110 patients undergoing laparoscopic gynecological surgery with an estimated operative time of more than 2 hours under general anesthesia. The study was a randomized controlled study. The ONSD at various time points was measured by ultrasound, including when the patients entered the operating room (Tawake), after successful anesthesia induction and endotracheal intubation (Tinduction), when the body position was adjusted to the Trendelenburg position and the CO2 pneumoperitoneum pressure reached 14 mmHg, which was recorded as T0. Then, measurements were conducted every 15 minutes for first 1 hour and then once every hour until the end of the surgery（T15,T30,T45 ,T1h ,T2h…）, after end of surgery and the tracheal tube was removed (Tend), and before the patients were transferred to the ward (Tpacu).Results A significant difference in optic nerve sheath diameter was found between two groups at T15, T30, T45 (4.64±0.48mm and 4.50±0.29mm, respectively, p =0.031; 4.77±0.45mm and 4.62±0.28mm, respectively, p =0.036; 4.84±0.46mm and 4.65±0.30mm, respectively, p =0.012), while no significant difference at Tawake and other time points. Conclusion During laparoscopic gynecological surgery lasting more than 2 hours, the optic nerve sheath diameter gradually increased with establishment of the CO2 pneumoperitoneum and patient placement in the Trendelenburg position in both sevoflurane group and propofol group and returned to baseline 1 hour after surgery. No significant difference was observed between the two groups 1 hour after surgery. Trial registration clinicaltrials.gov，NCT03498235. Retrospectively registered 1 March2018,https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0007UMM&selectaction=Edit&uid=U00040C5&ts=39&cx=c7i8icThe manuscript adheres to CONSORT guidelines.

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Study of Optic Nerve Sheath Diameter in Normal Nepalese Adults Using Ultrasound

Birat Journal of Health Sciences ◽

10.3126/bjhs.v3i1.19758 ◽

2018 ◽

Vol 3 (1) ◽

pp. 357-360 ◽

Cited By ~ 1

Author(s):

Bidur KC ◽

Amit Thapa

Keyword(s):

Optic Nerve ◽

Optic Nerve Sheath Diameter ◽

Cross Sectional Study ◽

Optic Nerve Sheath ◽

P Value ◽

Cross Sectional ◽

Non Invasive ◽

Normal Limits ◽

Nerve Sheath ◽

Significant Difference

Introduction: Though invasive intracranial devices are gold standard to calculate intracranial pressure (ICP); these are not without any complications. Non-invasive measurement of ICP by Ultrasonography could be a safe and portable technique.Objectives: The objective of the study was to measure and compare values of optic nerve sheath diameter of both eyes in healthy Nepalese adults.Methodology: A prospective cross-sectional study of healthy adult Nepalese volunteers was performed using a 7.5 MHz linear Ultrasound probe on the closed eyelids; optic nerve sheath diameter (ONSD) was measured 3 mm behind the globe in each eye.Results: Optic nerve sheath diameter (ONSD) of both eyes was measured in 100 healthy volunteers of age ranged from 15 to 75 years with a mean of 30.21 ± 14.05 years. There were 18 (18%) male and 82 (82%) female. ONSD for right eye ranged from 3.20 to 4.90 mm with mean of 4.10 ± 0.50 mm and left eye from 3.20 to 4.80 mm with mean of 4.22 ± 0.49 mm. P value for right and left eye ONSD (P = 0.06) and male and female (P = 0.12 and 0.85 for right and left ONSD respectively) were within normal limits. ONSD has no correlation with age (P = 0.27 and 0.27 for right and left ONSD respectively).Conclusion Mean of optic nerve sheath diameter (ONSD) is 4.10mm and 4.22 mm for right and left eye respectively. There is no statistical significant difference in mean of ONSD between right and left eye. BJHS 2018;3(1)5 : 357-360

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PERBEDAAN OPTIC NERVE SHEATH DIAMETER (ONSD) PADA RESPONDEN NORMAL DAN NYERI KEPALA

Biomedika ◽

10.23917/biomedika.v11i2.8466 ◽

2019 ◽

Vol 11 (2) ◽

pp. 96-104

Author(s):

Sulistyani Sulistyani ◽

Rivan Danuaji

Keyword(s):

Optic Nerve ◽

Normal Volunteer ◽

Optic Nerve Sheath Diameter ◽

Optic Nerve Sheath ◽

Cross Sectional ◽

Average Value ◽

Normal People ◽

Nerve Sheath ◽

Significant Difference ◽

Transorbital Sonography

Nyeri kepala merupakan penanda adanya gangguan intrakranial. Nervus optikus merupakan saraf kranialis yang mudah dipengaruhi langsung adanya gangguan intrakranial. Kalimatnya Jumping. Kelainan nervus optikus dapat diketahui dengan adanya pelebaran optic nerve sheath diameter (ONSD). ONSD dapat diukur dengan transorbital sonografi yang bersifat nonimvasif. Penelitian ini bertujuan membedakan diameter ONSD pada orang yang nyeri kepala dan orang normal. Penelitian ini menggunakan pendekatan observasional analitik dengan metode cross sectional. Responden diambil dari pasien rawat inap dan responden normal. Hasil penelitian didapatkan rata – rata nilai ONSD pada pasien nyeri kepala adalah 0,52 ± 0,86 dan pada responden normal adalah 0,40 ± 0,57 (p < 0,05). Terdapat perbedaan signifikan nilai ONSD pada pasien normal dan nyeri kepala. Penelitian ini membuktikan bahwa terdapat gangguan intrakranial pada orang dengan nyeri kepala dan dapat digunakan sebagai deteksi dini.Kata Kunci: Optic Nerve Sheath Diameter (ONSD), Responden Normal, Nyeri KepalaHeadache is a sign of intracranial disorders. The optic nerve is a cranial nerve that is easily affected directly by intracranial disorders. The sentence is Jumping. Optic nerve abnormalities can be identified by the widening of the optic nerve sheath diameter (ONSD). ONSD can be measured by transorbital sonography which is nonimvasive. This study aims to distinguish the ONSD diameter in people with headaches and normal people. This research uses an analytic observational approach with cross sectional method. Respondents were taken from inpatients and normal respondents. The results showed that the average value of ONSD in headache patients was 0.52 ± 0.86 and in normal respondents was 0.40 ± 0.57 (p <0.05). There is a significant difference in the value of ONSD in normal patients and headaches. This research proves that there are intracranial disorders in people with headaches and can be used as early detection.Keyword: Optic nerve sheath diameter , headache , normal volunteer

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Reverse Trendelenburg position applied prior to pneumoperitoneum prevents excessive increase in optic nerve sheath diameter in laparoscopic cholecystectomy: randomized controlled trial

Journal of Clinical Monitoring and Computing ◽

10.1007/s10877-020-00608-6 ◽

2020 ◽

Author(s):

Serdar Demirgan ◽

Funda Gümüş Özcan ◽

Ezgi Kargı Gemici ◽

Hasan Cem Güneyli ◽

Erkan Yavuz ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Laparoscopic Cholecystectomy ◽

Optic Nerve ◽

Controlled Trial ◽

Optic Nerve Sheath Diameter ◽

Optic Nerve Sheath ◽

Trendelenburg Position ◽

Randomized Controlled ◽

Nerve Sheath ◽

Reverse Trendelenburg Position

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Optic Nerve Sheath Diameter Is Not Related to High Altitude Headache: A Randomized Controlled Trial

High Altitude Medicine & Biology ◽

10.1089/ham.2012.1019 ◽

2012 ◽

Vol 13 (3) ◽

pp. 193-199 ◽

Cited By ~ 16

Author(s):

Justin Stevan Lawley ◽

Samuel James Oliver ◽

Paul Mullins ◽

Daniel Morris ◽

Naushad Ali Junglee ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Optic Nerve ◽

High Altitude ◽

Controlled Trial ◽

Optic Nerve Sheath Diameter ◽

Optic Nerve Sheath ◽

Randomized Controlled ◽

Nerve Sheath

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Study of Changes in Optic Nerve Sheath Diameter Following Tracheal Intubation Using Macintosh Laryngoscope or Fibreoptic-Guided Intubation Through Ambu Aura-I: A Randomised Controlled Study

Cureus ◽

10.7759/cureus.19782 ◽

2021 ◽

Author(s):

Daljinder Singh ◽

Akashdeep Singh ◽

Ashim Sharma ◽

Kuldip Sandhu

Keyword(s):

Optic Nerve ◽

Tracheal Intubation ◽

Macintosh Laryngoscope ◽

Optic Nerve Sheath Diameter ◽

Optic Nerve Sheath ◽

Controlled Study ◽

Nerve Sheath ◽

Randomised Controlled Study ◽

Randomised Controlled

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Evaluation of Increased Intracranial Pressure with the Optic Nerve Sheath Diameter by Ultrasound in Epiduroscopic Neural Laser Discectomy Procedures

January 2018 - Pain Physician ◽

10.36076/ppj.2021.24.e595 ◽

2021 ◽

pp. E595-E600

Keyword(s):

Optic Nerve ◽

Intracranial Pressure ◽

Processing Time ◽

Optic Nerve Sheath Diameter ◽

Optic Nerve Sheath ◽

Increased Intracranial Pressure ◽

Fluid Delivery ◽

Nerve Sheath ◽

Randomized Controlled Studies ◽

Significant Difference

BACKGROUND: In order to clarify the camera image and open the adhesions mechanically during epiduroscopy, saline is injected continuously in the epidural area. As a result, an increase in intracranial pressure is to be expected in theory. Increased intracranial pressure can be evaluated by measuring by optic nerve sheath diameter. OBJECTIVES: This study was designed to evaluate the relationship between optic nerve sheath diameter measurements and intracranial pressure, after injecting fluid to the epidural area during epiduroscopy procedures performed in our clinic. STUDY DESIGN: Retrospective study. SETTING: Sakarya University Training and Research Hospital. METHODS: During the epiduroscopy procedure, pre and postoperative bilateral optic nerve sheath diameters were measured with an ultrasonography probe. With the patients’ eyelids closed, the probe was placed on the orbita in the sagittal plane, measuring 3 mm posterior of the papilla. RESULTS: While there was a statistically significant difference between pre- and post-operative optic nerve sheath diameter measurements, there was no significant correlation with processing time, amount of fluid delivered, or fluid delivery rates. LIMITATIONS: One of the limitations of this study is the retrospective collection of data. A second limitation is that repetitive measurements were not performed, instead of a single postoperative measurement. CONCLUSION: We think more prospective randomized controlled studies are required to examine the increase in the diameter of the optic nerve sheath, which is an indirect indicator of increased intracranial pressure after epiduroscopy applications, in order to determine whether the pressure increase is associated with the rate of fluid delivery, the total fluid amount, or the processing time. KEY WORDS: Epidural, epiduroscopic laser neural decompression, fluid volume, intracranial pressure, optic nerve sheath diameter, ultrasonography, rate

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