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Position does not affect the optic nerve sheath diameter during laparoscopy.

Kim SH, Kim HJ, Jung KT - Korean J Anesthesiol (2015)

Bottom Line: Group RT: laparoscopic cholecystectomy, Reverse trendelenburg position, n = 30).Parameters were measured at 6 time points during surgery.However, no significant differences in changes of ONSD, PaCO2, ETCO2, and MAP were observed between two groups.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology and Pain Medicine, Chosun University Hostpital, Gwangju, Korea.

ABSTRACT

Background: Increase in intracranial pressure (ICP) is one of the physiologic changes during laparoscopic surgery, which is known to be associated with positional changes. Changes of ICP can be measured directly by invasive method, but ultrasonographic measurement of optic nerve sheath diameter (ONSD) is known to be a rapidly applicable technique for evaluating ICP. The aim of this study is to investigate the change of ONSD according to the positional change during laparoscopic surgery.

Methods: Female patients scheduled to undergo laparoscopic surgery were enrolled. Fifty-seven patients were assigned according to the position during surgery (Group T: gynecological surgery, Trendelenburg position, n = 27 vs. Group RT: laparoscopic cholecystectomy, Reverse trendelenburg position, n = 30). After induction of anesthesia, ONSD, PaCO2, end-tidal carbon dioxide (ETCO2), and mean arterial pressure (MAP) were measured. Parameters were measured at 6 time points during surgery.

Results: There were no significant differences in the demographic data of patients, procedure time, and anesthesia. After pneumoperitoneum and positional change, ONSD, ETCO2, and MAP increased in both groups until 15 min and returned to the baseline. However, no significant differences in changes of ONSD, PaCO2, ETCO2, and MAP were observed between two groups.

Conclusions: ONSD during laparoscopic surgery with pneumoperitoneum increased slightly until 15 minutes, but there were no significant differences according to the position. Increases in ICP during laparoscopic surgery with short period of pneumoperitoneum would be small in disregard of position in patients without intracranial pathology.

No MeSH data available.


Related in: MedlinePlus

Changes of mean arterial pressure during laparoscopic surgery. Group T: laparoscopic gynecological surgery with Trendelenburg position during surgery, Group RT: laparoscopic cholecystectomy with reverse Trendelenburg position during surgery. T0: baseline (before introducing pneumoperitoneum), T1: 5 minutes after introducing pneumoperitoneum and positional change, T2: 10 minutes after introducing pneumoperitoneum and positional change, T3: 15 minutes after introducing pneumoperitoneum and positional change, T4: 30 minutes after introducing pneumoperitoneum and positional change, T5: 5 minutes after discontinuing pneumoperitoneum and the patient's position has returned to supine. *P < 0.05 compared with baseline value at T0.
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Figure 2: Changes of mean arterial pressure during laparoscopic surgery. Group T: laparoscopic gynecological surgery with Trendelenburg position during surgery, Group RT: laparoscopic cholecystectomy with reverse Trendelenburg position during surgery. T0: baseline (before introducing pneumoperitoneum), T1: 5 minutes after introducing pneumoperitoneum and positional change, T2: 10 minutes after introducing pneumoperitoneum and positional change, T3: 15 minutes after introducing pneumoperitoneum and positional change, T4: 30 minutes after introducing pneumoperitoneum and positional change, T5: 5 minutes after discontinuing pneumoperitoneum and the patient's position has returned to supine. *P < 0.05 compared with baseline value at T0.

Mentions: After pneumoperitoneum and positional change, MAP, and ETCO2 increased in both groups (P < 0.001 in MAP and ETCO2, Figs. 2 and 3). However, no significant differences in changes of MAP and ETCO2 were observed between two groups (P = 0.868 in MAP; P = 0.226 in ETCO2). After 15 minutes from pneumoperitoneum and positional change, MAP, and ETCO2 returned to the baseline level in both groups. There were no significant differences in PaCO2 level during measurement period in both groups (P = 0.214, Fig. 3).


Position does not affect the optic nerve sheath diameter during laparoscopy.

Kim SH, Kim HJ, Jung KT - Korean J Anesthesiol (2015)

Changes of mean arterial pressure during laparoscopic surgery. Group T: laparoscopic gynecological surgery with Trendelenburg position during surgery, Group RT: laparoscopic cholecystectomy with reverse Trendelenburg position during surgery. T0: baseline (before introducing pneumoperitoneum), T1: 5 minutes after introducing pneumoperitoneum and positional change, T2: 10 minutes after introducing pneumoperitoneum and positional change, T3: 15 minutes after introducing pneumoperitoneum and positional change, T4: 30 minutes after introducing pneumoperitoneum and positional change, T5: 5 minutes after discontinuing pneumoperitoneum and the patient's position has returned to supine. *P < 0.05 compared with baseline value at T0.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4524934&req=5

Figure 2: Changes of mean arterial pressure during laparoscopic surgery. Group T: laparoscopic gynecological surgery with Trendelenburg position during surgery, Group RT: laparoscopic cholecystectomy with reverse Trendelenburg position during surgery. T0: baseline (before introducing pneumoperitoneum), T1: 5 minutes after introducing pneumoperitoneum and positional change, T2: 10 minutes after introducing pneumoperitoneum and positional change, T3: 15 minutes after introducing pneumoperitoneum and positional change, T4: 30 minutes after introducing pneumoperitoneum and positional change, T5: 5 minutes after discontinuing pneumoperitoneum and the patient's position has returned to supine. *P < 0.05 compared with baseline value at T0.
Mentions: After pneumoperitoneum and positional change, MAP, and ETCO2 increased in both groups (P < 0.001 in MAP and ETCO2, Figs. 2 and 3). However, no significant differences in changes of MAP and ETCO2 were observed between two groups (P = 0.868 in MAP; P = 0.226 in ETCO2). After 15 minutes from pneumoperitoneum and positional change, MAP, and ETCO2 returned to the baseline level in both groups. There were no significant differences in PaCO2 level during measurement period in both groups (P = 0.214, Fig. 3).

Bottom Line: Group RT: laparoscopic cholecystectomy, Reverse trendelenburg position, n = 30).Parameters were measured at 6 time points during surgery.However, no significant differences in changes of ONSD, PaCO2, ETCO2, and MAP were observed between two groups.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology and Pain Medicine, Chosun University Hostpital, Gwangju, Korea.

ABSTRACT

Background: Increase in intracranial pressure (ICP) is one of the physiologic changes during laparoscopic surgery, which is known to be associated with positional changes. Changes of ICP can be measured directly by invasive method, but ultrasonographic measurement of optic nerve sheath diameter (ONSD) is known to be a rapidly applicable technique for evaluating ICP. The aim of this study is to investigate the change of ONSD according to the positional change during laparoscopic surgery.

Methods: Female patients scheduled to undergo laparoscopic surgery were enrolled. Fifty-seven patients were assigned according to the position during surgery (Group T: gynecological surgery, Trendelenburg position, n = 27 vs. Group RT: laparoscopic cholecystectomy, Reverse trendelenburg position, n = 30). After induction of anesthesia, ONSD, PaCO2, end-tidal carbon dioxide (ETCO2), and mean arterial pressure (MAP) were measured. Parameters were measured at 6 time points during surgery.

Results: There were no significant differences in the demographic data of patients, procedure time, and anesthesia. After pneumoperitoneum and positional change, ONSD, ETCO2, and MAP increased in both groups until 15 min and returned to the baseline. However, no significant differences in changes of ONSD, PaCO2, ETCO2, and MAP were observed between two groups.

Conclusions: ONSD during laparoscopic surgery with pneumoperitoneum increased slightly until 15 minutes, but there were no significant differences according to the position. Increases in ICP during laparoscopic surgery with short period of pneumoperitoneum would be small in disregard of position in patients without intracranial pathology.

No MeSH data available.


Related in: MedlinePlus