This prospective interventional study will evaluate the effects of applying positive end-expiratory pressure (PEEP) at 10 cmH₂O on optic nerve sheath diameter (ONSD) in patients undergoing elective laparoscopic cholecystectomy under general anesthesia. A total of approximately 80 adult patients (ASA physical status I-III) will be included following informed consent. ONSD will be measured using a high-frequency linear ultrasound probe at three predefined intraoperative time points: (T0) 10 minutes after initiation of mechanical ventilation, (T1) 10 minutes after pneumoperitoneum creation, and (T2) 30 minutes after pneumoperitoneum creation. Dynamic lung compliance, peak airway pressure (Ppeak), end-tidal CO₂ (EtCO₂), heart rate, mean arterial pressure, and SpO₂ will also be recorded. The aim is to assess whether the application of PEEP influences intracranial pressure indicators, particularly ONSD, during laparoscopic procedures. The study may provide valuable insights into the neurophysiological effects of intra-abdominal pressure and mechanical ventilation strategies in surgical patients.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
50
Application of 10 cmH₂O PEEP during mechanical ventilation after pneumoperitoneum creation in patients undergoing laparoscopic cholecystectomy.
Niğde Training and Research Hospital
Niğde, Niğde Province, Turkey (Türkiye)
RECRUITINGChange in Optic Nerve Sheath Diameter (ONSD)
ONSD will be measured via ultrasound at 3 time points during surgery.
Time frame: Intraoperative; T0, T1, T2
Change in Peak Airway Pressure (Ppeak)
Peak airway pressure will be measured using the ventilator settings at three predefined intraoperative time points to evaluate respiratory mechanics during PEEP application.
Time frame: Intraoperative measurement at T0, T1, and T2
Change in Dynamic Lung Compliance
Dynamic lung compliance will be calculated using the formula: Tidal Volume / (Ppeak - PEEP) and measured at three intraoperative time points.
Time frame: Intraoperative measurement at T0, T1, and T2
Change in End-Tidal Carbon Dioxide (EtCO₂)
End-tidal CO₂ levels will be recorded intraoperatively to monitor changes in ventilation efficiency during surgery.
Time frame: Intraoperative measurement at T0, T1, and T2
Changes in Heart Rate (HR) and Mean Arterial Pressure (MAP) Time Frame
Heart rate and mean arterial pressure will be recorded at predefined time points to assess hemodynamic stability during surgery.
Time frame: Intraoperative measurement at T0, T1, and T2
Peripheral Oxygen Saturation (SpO₂)
Peripheral oxygen saturation will be monitored continuously and recorded at specified intraoperative time points.
Time frame: Intraoperative continuous monitoring and recorded at T0, T1, and T2
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