The Effect of Head Position on the Optik Nerve Sheath Diameter in Patients During Thyroid Surgery

Istanbul University - Cerrahpasa49 enrolled

Overview

THE EFFECT OF HEAD POSİTİON ON THE OPTİC NERVE SHEATH DİAMETER İN PATİENTS DURİNG THYROİD SURGERY

Aim: In thyroidectomy surgery, the patient's head is placed in hyperextension and the patient is placed in a semi-sitting position to facilitate access to the surgical site. This position of the head causes a decrease in venous return or partial obstruction of venous return due to stretching of the neck veins. The aim of our study is to demonstrate the effect of surgical position on intracranial pressure by measuring the optic nerve sheath diameter (OSSD) using ultrasonography in patients undergoing thyroid surgery and to determine its correlation with post-operative headaches. Material And Method: Our study was conducted prospectively and randomly in patients undergoing elective total thyroidectomy. Patients aged 18-65 with an ASA score of 1-2 and an operation time of less than 4 hours were included in our study. Patients were positioned in the semi-Fowler position with a 30° extension of the head. Bilateral OSSD surgical positioning was applied, and after ensuring haemodynamic stability for 5 minutes and at the end of the operation, measurements were taken twice using ultrasound, and the average was recorded. The Visual Analogue Scale (VAS) was used to assess postoperative pain intensity. Headache was assessed and recorded at 15 minutes, 30 minutes, 1 hour, 24 hours, 3 days, and 7 days postoperatively.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Thyroid Cancer Thyroid and Parathyroid Surgery Thyroid Adenoma

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Patients aged between 18 and 65, with an ASA score between 1 and 2 according to the American Society of Anesthesiologists (ASA) physical status classification system * whose surgery duration was expected to be less than 4 hours were included in our study. Exclusion Criteria: * liver failure * kidney failure * intracranial masses * history of hydrocephalus, * migraine * chronic hypoxemia or hypercarbic lung disease * additional heart disease * hemodynamic insufficiency * neurological and psychiatric diseases, * glaucoma * patients in whom ocular USG could not provide adequate images * patients with pathological problems involving the eyelid and its surrounding area * patients with diseases such as periorbital cellulitis * patients with preoperative headache complaints * patients with known diseases that could cause increased intracranial pressure * patients who refused to participate in the study were excluded from the study.

Locations (1)

Istanbul University Cerrahpasa

Istanbul, FATİH, Turkey (Türkiye)

Outcomes

Primary Outcomes

OPTİC NERVE SHEATH DİAMETER

CHANGE İN OPTİC NERVE SHEATH DİAMETER MEASURED BY ULTRASOUND BEFORE AND AFTER POSİTİONİNG DURİNG THYROİDECTOMY

Time frame: INTRAOPERATİVE PERİOD(FROM İNDUCTİON TO THE END OF SURGERY)

Secondary Outcomes

POSTOPERATİVE HEADACHE SEVERİTY (VISUAL ANALOG SCALE)

THE SEVERİTY OF POSTOPERATİVE HEADACHE WİLL BE ASSESSED USİNG A VİSUAL ANALOG SCALE. THE LOWEST POSSIBLE SCORE ON THE VISUAL ANALOG SCALE WAS 0, AND THE HIGHEST POSSIBLE SCORE WAS 10.

Time frame: WİTHİN SEVEN DAYS AFTER SURGERY

Data from ClinicalTrials.gov

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