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Child's Nervous System

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01-05-2020 | Ultrasound | Original Article

Effects of prone positioning with neck extension on intracranial pressure according to optic nerve sheath diameter measured using ultrasound in children

Authors: Soo-Bin Yoon, Sang-Hwan Ji, Young-Eun Jang, Ji-Hyun Lee, Eun-Hee Kim, Jin-Tae Kim, Hee-Soo Kim

Published in: Child's Nervous System | Issue 5/2020

Abstract

Purpose

Optic nerve sheath diameter has been used for measure of intracranial pressure. The aim of this study was to evaluate the effect of prone positioning with neck extension on intracranial pressure in infants undergoing craniosynostosis surgery and to determine precautions using optic nerve sheath diameter measurement.

Methods

We enrolled 30 infants who were scheduled for correction of craniosynostosis in which planning included the prone position with neck extension. Optic nerve sheath diameter (anterior/lateral transbulbar approach) was measured 5 times in each eyeball at the following time points: 15 min after intubation in supine position as the baseline value (supine 1); 10 min after final surgical position before skin incision (prone); and 10 min after returning to supine position at the conclusion of surgery (supine 2). Hemodynamic parameters, airway peak pressure, oxygen saturation, and E_TCO₂ were monitored. Data were analyzed using repeated-measures multivariate analysis of variance to evaluate the effect of different positions under anesthesia on changes in using optic nerve sheath diameter and P < 0.05 was considered to be statistically significant.

Results

There was no difference in optic nerve sheath diameter after prone position with neck extension in all the measure. After surgery, optic nerve sheath diameter was decreased compared with the preoperative baseline values (Rt anterior/lateral 5.6/5.5: 5.4/5.2; Lt anterior/lateral 5.6/5.5: 5.4/5.3, P < 0.05, respectively).

Conclusions

In conclusion, prone positioning with head extension did not further increase intracranial pressure, although the surgical procedure could reduce intracranial pressure in the immediate postoperative period in infants undergoing craniosynostosis surgery.

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Title: Effects of prone positioning with neck extension on intracranial pressure according to optic nerve sheath diameter measured using ultrasound in children
Authors: Soo-Bin Yoon
Sang-Hwan Ji
Young-Eun Jang
Ji-Hyun Lee
Eun-Hee Kim
Jin-Tae Kim
Hee-Soo Kim
Publication date: 01-05-2020
Publisher: Springer Berlin Heidelberg
Keywords: Ultrasound
Intracranial Hypertension
Craniosynostosis
Ultrasound
Published in: Child's Nervous System / Issue 5/2020
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-019-04442-3

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Effects of prone positioning with neck extension on intracranial pressure according to optic nerve sheath diameter measured using ultrasound in children

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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