Laparoscopic surgeries require pneumoperitoneum and Trendelenburg position, which may lead to increased intracranial pressure (ICP). Optic nerve sheath diameter (ONSD) measurement via ultrasound is a non-invasive method to evaluate ICP. This prospective study aims to compare the effects of sevoflurane and desflurane on ONSD in patients undergoing laparoscopic hysterectomy and bilateral oophorectomy in the Trendelenburg position.
The primary objective of this study is to compare the ONSD values measured by ultrasound between the sevoflurane and desflurane groups. The secondary objective is to evaluate the relationship between ONSD changes, hemodynamic parameters, and postoperative neurological complications.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
60
Anesthesia maintenance will be provided with sevoflurane at 1 MAC in a 40% oxygen-air mixture.
Anesthesia maintenance will be provided with desflurane at 1 MAC in a 40% oxygen-air mixture.
Istanbul Medipol University
Istanbul, Turkey (Türkiye)
RECRUITINGOptic Nerve Sheath Diameter (ONSD)
Three measurements will be taken in the transverse and sagittal planes for each eye and the average will be calculated.
Time frame: Intraoperative (approx. 2-4 hours): immediately and 10 min post-intubation, 10 and 60 min post-Trendelenburg/pneumoperitoneum, 10 min post-neutral position."
Mean Arterial Pressure (MAP)
Mean arterial pressure will be measured via non-invasive blood pressure monitoring or invasive radial artery cannulation.
Time frame: Intraoperative (approx. 2-4 hours): immediately and 10 min post-intubation, 10 and 60 min post-Trendelenburg/pneumoperitoneum, 10 min post-neutral position."
Heart Rate (HR)
Heart rate will be continuously monitored and recorded using electrocardiography (ECG).
Time frame: Intraoperative (approx. 2-4 hours): immediately and 10 min post-intubation, 10 and 60 min post-Trendelenburg/pneumoperitoneum, 10 min post-neutral position."
Peripheral Oxygen Saturation (SpO2)
Oxygen saturation will be monitored continuously using pulse oximetry.
Time frame: Intraoperative (approx. 2-4 hours): immediately and 10 min post-intubation, 10 and 60 min post-Trendelenburg/pneumoperitoneum, 10 min post-neutral position."
End-tidal Carbon Dioxide (EtCO2)
End-tidal carbon dioxide levels will be measured using capnography monitoring.
Time frame: Intraoperative (approx. 2-4 hours): immediately and 10 min post-intubation, 10 and 60 min post-Trendelenburg/pneumoperitoneum, 10 min post-neutral position."
Arterial pH
Arterial pH levels will be evaluated from arterial blood gas analysis samples.
Time frame: Intraoperative (approx. 2-4 hours): immediately and 10 min post-intubation, 10 and 60 min post-Trendelenburg/pneumoperitoneum, 10 min post-neutral position."
Partial Pressure of Carbon Dioxide (pCO2)
pCO2 levels will be evaluated from arterial blood gas analysis samples.
Time frame: Intraoperative (approx. 2-4 hours): immediately and 10 min post-intubation, 10 and 60 min post-Trendelenburg/pneumoperitoneum, 10 min post-neutral position."
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