Ventilation Modes Effect on Intracranial Pressure During Laparoscopic Colectomy by Optic Nerve Sheath Diameter

Mansoura University

Status: Unknown

Conditions: Laparoscopic Colectomy

Treatments: Device: Volume control ventilation group; Device: Pressure control ventilation-volume guaranteed group

Study type: Interventional

Funder types: Other

Identifiers

NCT05268900

MD/ 21.10.553

Details and patient eligibility

About

Patients who undergo laparoscopic surgery often experience increased intracranial pressure (ICP). In laparoscopic colectomy surgery, the duration always exceeds 2h with more liability to changes in arterial blood gases, hemodynamics, also the patient is in Trendelenburg position about 30° head down, Trendelenburg position is believed to create changes in hemodynamics, respiratory mechanics, metabolic response, and ICP as it affects vital organs especially if steep positioning. Various modes of mechanical ventilation have been experimented to achieve good intraoperative oxygenation which may cause changes in arterial blood gas values and hemodynamic parameters that might lead to changes in the ICP. In this study we will measure ONSD, basal, intraoperative, and in the PACU to evaluate the effect of different ventilation modes (both VCV mode and PCV-VG mode) on intracranial pressure.

Full description

The aim of the current study is to compare the effect of volume control ventilation (VCV) versus pressure control ventilation-volume guaranteed (PCV-VG) as modes of mechanical ventilation on ICP by US guided ONSD measurement during laparoscopic colectomy,

Enrollment: 78 estimated patients

Sex: All

Ages: 21 to 50 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Body mass index less than 30
• American Society of Anesthesiologist physical class I -III.

Exclusion criteria

• Patient refusal
• operative time < 2 hour (h)
• Patients with preexisting eye disease.
• History of eye surgery
• Optic nerve disease.
• Causes of elevated ICP.

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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78 participants in 2 patient groups, including a placebo group

Volume control ventilation group

Placebo Comparator group

Description:

Patients' lungs will be ventilated with volume control ventilation mode

Treatment:

Device: Volume control ventilation group

Pressure control ventilation-volume guaranteed group

Active Comparator group

Description:

patients' lungs will be ventilated with Pressure control ventilation-volume guaranteed mode

Treatment:

Device: Pressure control ventilation-volume guaranteed group