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Comparison of Changes in the Optic Nerve Sheath Diameter Following Thoracic Epidural Normal Saline Injection in Laparoscopic Surgery

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Author(s)
Ji Seob KimJi Hee HongJi Hoon Park
Keimyung Author(s)
Kim, Ji SeobHong, Ji HeePark, Ji Hoon
Department
Dept. of Anesthesiology & Pain Medicine (마취통증의학)
Journal Title
Pain Physician
Issued Date
2022
Volume
25
Issue
4
Keyword
Laparoscopyoptic nerve sheath diameterepiduralanalgesiaintracranialpostoperative
Abstract
OBJECTIVES:
The purpose of this study is to investigate changes in the ONSD following thoracic epidural normal saline injection during laparoscopic surgery.

STUDY DESIGN:
Prospective randomized trial.

SETTING:
An interventional pain management clinic in South Korea

METHOD:
This study included 60 patients receiving thoracic epidural catheterization for postoperative pain control following laparoscopic or open gastrectomy. Patients were divided into 3 groups. The open group consisted of patients undergoing open gastrectomy without epidural normal saline injection. The lapa-saline and lapa groups consisted of patients undergoing laparoscopic gastrectomy with and without 10 mL epidural normal saline injection, respectively. The ONSD was measured using ultrasound at 4 time points.

RESULTS:
The lapa-saline group showed the most pronounced increase in the ONSD compared to the open and lapa groups at the time points of T1 and T2. Only the lapa-saline group demonstrated 4 patients with ONSD values of more than 5.8 mm. The increase in the ONSD continued even after the deflation of pneumoperitoneum in the lapa-saline group, whereas the ONSD in the lapa group returned to near baseline value after the deflation of pneumoperitoneum.

LIMITATIONS:
Epidural normal saline was injected instead of a local anesthetic to prevent the occurrence of hypotension. However, the injection of epidural normal saline is considered to be the same physiological condition causing elevation of ICP compared with epidural injection with local anesthetics.

CONCLUSIONS:
The lapa-saline group showed the most pronounced increase in the ONSD. The ONSD values higher than 5.8 mm were observed only in the lapa-saline group. The increase in the ONSD continued even after the deflation of pneumoperitoneum only in the lapa-saline group.
Keimyung Author(s)(Kor)
김지섭
홍지희
박지훈
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
2150-1159
Source
https://www.painphysicianjournal.com/linkout?issn=&vol=25&page=E563
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44399
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Anesthesiology & Pain Medicine (마취통증의학)
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