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Comparison of the effects of normal and low blood pressure regulation on the optic nerve sheath diameter in robot assisted laparoscopic radical prostatectomy

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Affiliated Author(s)
박지훈홍지희김지섭
Alternative Author(s)
Park, Ji HoonHong, Ji HeeKim, Ji Seob
Journal Title
Anesth Pain Med
ISSN
2383-7977
Issued Date
2021
Keyword
Blood pressureCerebral oxygen saturationOptic nerve sheath diameterPneumoperitoneumTrendelenburg position
Abstract
Background:
Robot-assisted laparoscopic radical prostatectomy is an advanced and popular surgical technique. However, increased intracranial pressure which is caused by CO2 pneumoperitoneum and Trendelenburg position is the main cerebrovascular effect. Measurement of optic nerve sheath diameter using ocular ultrasound is a noninvasive and reliable method for the assessment of intracranial pressure. The primary endpoint of this study was to identify whether low blood pressure regulation has any benefit in attenuating an increase of optic nerve sheath diameter during robot-assisted laparoscopic radical prostatectomy.

Methods:
Optic nerve sheath diameter and cerebral oxygen saturation were measured at baseline (supine position), one and two hours after pneumoperitoneum and Trendelenburg position respectively, and after return to supine position in normal (n = 27) and low blood pressure groups (n = 24).

Results:
Mean optic nerve sheath diameter values measured at one and two hours after pneumoperitoneum and Trendelenburg position were significantly increased compared to the baseline value (P < 0.001 in normal blood pressure group; P = 0.003 in low blood pressure group). However, the mean optic nerve sheath diameter and cerebral oxygen saturation measured at any of the time points as well as degrees of change between the two groups did not show any significant changes. The peak values of optic nerve sheath diameter in normal and low blood pressure groups demonstrated 14.9% and 9.2% increases, respectively.

Conclusions:
Low blood pressure group demonstrated an effect in maintaining an increase of optic nerve sheath diameter less than 10% during CO2 pneumoperitoneum and Trendelenburg position.
Department
Dept. of Anesthesiology &amp; Pain Medicine (마취통증의학)
Publisher
School of Medicine (의과대학)
Citation
Ji Hoon Park. (2021). Comparison of the effects of normal and low blood pressure regulation on the optic nerve sheath diameter in robot assisted laparoscopic radical prostatectomy. Anesth Pain Med, 16(3), 248-257. doi: 10.17085/apm.20097
Type
Article
DOI
10.17085/apm.20097
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/43669
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Anesthesiology & Pain Medicine (마취통증의학)
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