Optical Nerve Sheath Changes During Head Down Laparoscopy

ASST Fatebenefratelli Sacco

Status: Completed

Conditions: Brain Edema; Pneumoperitoneum; Surgery, Laparoscopic; Intracranial Hypertension

Treatments: Diagnostic Test: Optical nerve sheath diameter ultrasound measurement

Study type: Observational

Funder types: Other

Identifiers

NCT03957837

RIA02/2019

Details and patient eligibility

About

Patient undergoing laparoscopic radical prostatectomy in steep trendelenburg position are at risk to develop complication from brain edema.

Ultrasound assessment of optical nerve sheath diameter is a simply, non-invasive method to estimate the increase of intracranial pressure. It is unknown how optical nerve sheath diameter changes after prolonged head down position.

Enrollment: 20 patients

Sex: Male

Ages: 18 to 70 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• patients undergoing elective laparoscopic prostatectomy in steep Trendelenburg position
• American Society of Anesthesiologists risk I-III

Exclusion criteria

• Age <18 or >70 years
• American Society of Anesthesiologists risk >III
• Assumption of beta-2-blockers, diuretics
• Heart failure with NYHA class ≥ IIb
• Diabetes with ocular (i.e. retinopathy), neurologic (i.e. peripheral neuropathy), or renal complications
• History of cardiac surgery, thoracic surgery, suprainguinal vascular surgery, head surgery, ocular surgery, stroke, hydrocephalus.

Trial design

20 participants in 2 patient groups

Steep Trendelenburg

Description:

Patients undergoing elective laparoscopic prostatectomy in steep Trendelenburg position (25 degrees head down position)

Treatment:

Diagnostic Test: Optical nerve sheath diameter ultrasound measurement

Healthy controls

Description:

Healthy awake volunteers undergoing steep Trendelenburg position (25 degrees head down position)

Treatment:

Diagnostic Test: Optical nerve sheath diameter ultrasound measurement