Optical Nerve Sheath Changes During Head Down Laparoscopy

ASST Fatebenefratelli Sacco20 enrolled

Overview

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.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Intracranial Hypertension Brain Edema Pneumoperitoneum Surgery, Laparoscopic

Interventions

Optical nerve sheath diameter ultrasound measurementDIAGNOSTIC_TEST

In cases: ultrasound measurement of the diameter of the optical nerve sheath at (T1) baseline before the induction of general anesthesia (5 min after the beginning of mechanical ventilation in supine position); (T2) after 10 min from 25 degrees head down positioning and with pneumoperitoneum insufflation; (T3) after 60 min from T2, in head down position; (T4) after 10 min from tracheal tube removal, in supine position. In healthy controls: ultrasound measurement of the diameter of the optical nerve sheath at (T1) baseline in supine position; (T2) after 10 min from 25 degrees head down positioning; (T3) after 60 min from T2, in a head down position; (T4) after 10 min from positioning supine

Eligibility

Sex: MALEMin age: 18 YearsMax age: 70 YearsHealthy volunteers:

Medical Language ↔ Plain English

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.

Locations (1)

ASST Fatebenefratelli Sacco, Luigi Sacco Hospital

Milan, Italy

Outcomes

Primary Outcomes

Optical nerve sheath diameter changes during steep Trendelenburg position

changes of optical nerve sheath diameter in millimeters measured by ultrasound in patients undergoing laparoscopic radical prostatectomy and in healthy volunteers

Time frame: 2 months

Data from ClinicalTrials.gov

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