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Surgical Endoscopy

Published in:

01-01-2018

Ultrasonographic optic nerve sheath diameter for predicting elevated intracranial pressure during laparoscopic surgery: a systematic review and meta-analysis

Authors: Eun Jung Kim, Bon-Nyeo Koo, Seung Ho Choi, Kyoungun Park, Min-Soo Kim

Published in: Surgical Endoscopy | Issue 1/2018

Abstract

Background

Laparoscopic surgery involves the creation of a carbon dioxide (CO₂) pneumoperitoneum to facilitate a clear surgical view, which may result in an elevated intracranial pressure (ICP). Depending on the surgical area, steep Trendelenburg positioning may be used as well, further increasing the ICP. The objective of this study was to assess the effects of laparoscopic surgery on changes in ICP assessed by ultrasonographic measurement of optic nerve sheath diameter (ONSD), which is a generally accepted simple, reliable, and non-invasive ICP measurement technique.

Methods

A computerized literature search was performed in August 2016 to identity prospective studies that measured ONSD to assess ICP changes during laparoscopic surgery. The primary outcome was the change in ONSD during the early (0–30 min) and late (30–120 min) periods after initiating pneumoperitoneum, compared with baseline values measured after anesthesia induction. Mean differences (MDs) with 95% confidence intervals [CIs] were calculated.

Results

Nine observational studies and one randomized controlled trial, with a total of 460 subjects, were analyzed. Compared to the baseline value after anesthesia induction, significant increases in ONSD were observed in both the early period (MD 0.46, 95% CI 0.31–0.61, P < 0.001, I ² = 97.3%) and late period (MD 0.67, 95% CI 0.20–1.14, P = 0.005, I ² = 99.2%). Comparing the ONSD during the early and late periods revealed no significant differences over time.

Conclusions

The current meta-analysis revealed that ICP elevation during laparoscopy could be anticipated through a significant increase in the ONSD in the early (0–30 min) and late (30–120 min) periods during CO₂ pneumoperitoneum.

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Title: Ultrasonographic optic nerve sheath diameter for predicting elevated intracranial pressure during laparoscopic surgery: a systematic review and meta-analysis
Authors: Eun Jung Kim
Bon-Nyeo Koo
Seung Ho Choi
Kyoungun Park
Min-Soo Kim
Publication date: 01-01-2018
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 1/2018
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-017-5653-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Ultrasonographic optic nerve sheath diameter for predicting elevated intracranial pressure during laparoscopic surgery: a systematic review and meta-analysis

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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