Clinical Trials Logo

Clinical Trial Summary

Trendelenburg position and carbon dioxide (CO2) pneumoperitoneum are in association with increased intracranial pressure (ICP) reflected by the optic nerve sheath diameter (ONSD). Measurement of ONSD by ultrasound (US) guidance can be used in the diagnosis of ICP. The investigators interrogated the effects of lateral 45° downward position and CO2 insufflation on ONSD in patients undergoing laparoscopic transperitoneal nephrectomy.


Clinical Trial Description

Transperitoneal laparoscopic nephrectomy is a popular and increasingly used alternative to the laparoscopic retroperitoneal approach because of benefits such as minimal invasion, the transperitoneal path provides a larger working space and familiar anatomic landmarks. This technique requires a steep (35° to 45°) lateral downward (SLD) position and a CO2 pneumoperitoneum. SLD may lead to pathophysiological changes such as pulmonary dysfunction with the formation of atelectasis and increasing airway pressure as well as ocular complications. These are firstly reported 2 patients with bilateral ischaemic optic neuropathy (ION) after a da Vinci robotic-assisted procedure. SLD has raised concerns that prolonged elevation of venous pressure in the head may increase the risk of developing ION. However, a few investigations have yet been made into intraoperative changes in intraocular pressure (IOP) and optic nerve sheath diameter (ONSD) - correlating with intracranial pressure (ICP) - and their adverse ocular effects. The operative conditions get better the steeper the positioning, providing an excellent intraabdominal view and probably less bleeding. The hypothesis of the study is that patients placed in SLD for several hours have a high risk for ocular changes and peri- and postoperative complications. The aim of this study was to investigate the influence of capnoperitoneum and permanent 45° SLD on IOP and ONSD in patients undergoing laparoscopic transperitoneal nephrectomy. The investigators also analyzed the hemodynamic and respiratory parameters, duration of surgery during laparoscopic nephrectomy. Perioperative and postoperative complications were also recorded. ;


Study Design


Related Conditions & MeSH terms


NCT number NCT05185908
Study type Observational
Source Istanbul University
Contact
Status Completed
Phase
Start date December 1, 2016
Completion date January 1, 2019

See also
  Status Clinical Trial Phase
Recruiting NCT02697825 - Intraocular Pressure Versus Optic Nerve Sheath Diameter N/A
Not yet recruiting NCT04092036 - Optic Nerve Sheath Diameter in Prediction of Fluid Responsiveness
Not yet recruiting NCT03691025 - Association of the Optic Nerve Sheath Diameter With Eyeball Transverse Diameter in Robot-assisted Prostatectomy
Completed NCT03362255 - Measurement of Optic Nerve Sheath Diameter N/A
Completed NCT04412109 - Optic Nerve Sheath Diameter Difference Between Different Injection Volume N/A
Recruiting NCT04826042 - Effect of Contrast Medium on Optic Nerve Sheath Diameter N/A
Completed NCT03152981 - Analysis of Change of Optic Nerve Sheath Diameter in Robot Assisted Laparoscopic Radical Prostatectomy N/A
Completed NCT03131245 - Optic Nerve Sheath Diameter in Craniosynostosis
Recruiting NCT04910087 - The Effect of Anesthesia Management on Optic Nerve Sheath Diameter in the Ercp Procedures N/A
Recruiting NCT04507620 - Effect of Cervical Immobilization on Optic Nerve Sheath Diameter
Not yet recruiting NCT04427085 - Changes of Optic Nerve Sheath Diameter Between Obese and Non-obese Patients Undergoing Laparoscopic Gynecological Surgery N/A
Completed NCT04765397 - Different Resectoscopes Effects to Optic Nerve Sheath Diameter N/A
Not yet recruiting NCT04955925 - Effect of Sevoflurane and Propofol on the Optic Nerve Sheath Diameter
Completed NCT03634176 - Optic Nerve Sheath Diameter in Retrobulbar Ultrasound as a Surrogate Measure for Intracranial Pressure Before and After Non-invasive Strategies
Recruiting NCT04758013 - Comparison of Changes of ONSD Between Groups of Laparoscopic Surgery With and Without Epidural Saline Injection N/A
Completed NCT03609879 - Effect of Cervical Collar on Intracranial Pressure N/A
Completed NCT04407715 - Anesthesia on Optic Nerve Sheath Diameter N/A
Not yet recruiting NCT04301817 - Changes in Optic Nerve Sheath Diameter in Patients Undergoing Spinal Surgery in the Prone Position
Completed NCT04339244 - Effect of Pressure Regulation on Optic Nerve Sheath Diameter N/A