Predictive role of optic nerve sheath diameter for postoperative cognitive dysfunction following long-standing Trendelenburg position in laparoscopic hysterectomy
Meliha Orhon Ergün, Feyza Özaltun, Seniyye Ülgen Zengin
Department of Anesthesiology and Reanimation, Pendik Research and Training Hospital, Marmara University Medical Faculty, Istanbul, Turkey
Giriş: Optic nerve sheath diameter (ONSD) is an indicator of intracranial pressure. This study aimed to examine the role of intraoperative ONSD measurements for predicting postoperative cognitive dysfunction in patients undergoing laparoscopic hysterectomy in Trendelenburg position with pneumoperitoneum.
Gereç ve Yöntem: Forty patients who underwent laparoscopic hysterectomy under long-standing Trendelenburg position (>2.5 hours) were included in this study. In addition to routine intraoperative monitoring, ONSD was measured intraoperatively at five time points. Its predictive role for postoperative cognitive dysfunction was assessed.
Bulgular: ONSD gradually increased in association with pneumoperitoneum and Trendelenburg position. No significant correlation was found between ONSD measurements and postoperative changes on cognitive function at the early postoperative period, day 3, and day 7. Patients who exhibited cognitive decline at day 7 (>2 point reduction in Mini-Mental State Examination score compared to baseline) did not differ in terms of ONSD measurements and other tested variables.
Tartışma ve Sonuç: Our findings suggest that intraoperative ONSD measurements do not seem to serve as a predictor for postoperative cognitive dysfunction in patients who underwent laparoscopic gynecological operations in long-standing Trendelenburg position and pneumoperitoneum.
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