Scholarlink

Background <p>This study aimed to compare the time-dependent changes in optic nerve sheath diameter (ONSD) associated with low-pressure (8&#xa0;mmHg) and high-pressure (14&#xa0;mmHg) pneumoperitoneum during laparoscopic cholecystectomy.</p> Methods <p>In this prospective, randomized, observer-blinded clinical trial, 76 adult patients with ASA physical status I–II were randomized into two groups receiving pneumoperitoneum at either 8&#xa0;mmHg (low-pressure group) or 14&#xa0;mmHg (high-pressure group). ONSD measurements were obtained using transorbital ultrasonography at five predefined time points (T0–T4). The primary outcome was the comparison of time-dependent changes in ONSD between the groups. Secondary outcomes included the incidence of postoperative nausea and vomiting and postoperative headache.</p> Results <p>All 76 patients were included in the final analysis. Baseline demographic characteristics and perioperative variables were comparable between the groups. Generalized linear model analysis demonstrated significant effects of group, time, and group × time interaction on ONSD (all <i>p</i> &lt; 0.001). ONSD increased after pneumoperitoneum induction in both groups; however, the increase was more pronounced in the high-pressure group, particularly at T1 and T2. At the second postoperative hour (T4), ONSD values in both groups approached baseline levels. The incidence of postoperative nausea, vomiting, and headache was significantly higher in the high-pressure group (nausea: <i>p</i> &lt; 0.001; vomiting: <i>p</i> = 0.018; headache: <i>p</i> = 0.001).</p> Conclusion <p>High-pressure pneumoperitoneum during laparoscopic cholecystectomy was associated with greater and more pronounced transient increases in optic nerve sheath diameter. This was accompanied by a higher incidence of early postoperative nausea, vomiting, and headache in the high-pressure group.</p> Trial registration <p>The trial was registered at ClinicalTrials.gov on August 20, 2025 (NCT07162922).</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Dynamic effects of low- and high-pressure pneumoperitoneum on optic nerve sheath diameter during laparoscopic cholecystectomy: a prospective, randomized, observer-blinded clinical trial

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年3月19日

查看全文
  • Engin Cetin,
  • Bedirhan Gunel,
  • Mehmet Yilmaz,
  • Ahmet Ergun

摘要

Background

This study aimed to compare the time-dependent changes in optic nerve sheath diameter (ONSD) associated with low-pressure (8 mmHg) and high-pressure (14 mmHg) pneumoperitoneum during laparoscopic cholecystectomy.

Methods

In this prospective, randomized, observer-blinded clinical trial, 76 adult patients with ASA physical status I–II were randomized into two groups receiving pneumoperitoneum at either 8 mmHg (low-pressure group) or 14 mmHg (high-pressure group). ONSD measurements were obtained using transorbital ultrasonography at five predefined time points (T0–T4). The primary outcome was the comparison of time-dependent changes in ONSD between the groups. Secondary outcomes included the incidence of postoperative nausea and vomiting and postoperative headache.

Results

All 76 patients were included in the final analysis. Baseline demographic characteristics and perioperative variables were comparable between the groups. Generalized linear model analysis demonstrated significant effects of group, time, and group × time interaction on ONSD (all p < 0.001). ONSD increased after pneumoperitoneum induction in both groups; however, the increase was more pronounced in the high-pressure group, particularly at T1 and T2. At the second postoperative hour (T4), ONSD values in both groups approached baseline levels. The incidence of postoperative nausea, vomiting, and headache was significantly higher in the high-pressure group (nausea: p < 0.001; vomiting: p = 0.018; headache: p = 0.001).

Conclusion

High-pressure pneumoperitoneum during laparoscopic cholecystectomy was associated with greater and more pronounced transient increases in optic nerve sheath diameter. This was accompanied by a higher incidence of early postoperative nausea, vomiting, and headache in the high-pressure group.

Trial registration

The trial was registered at ClinicalTrials.gov on August 20, 2025 (NCT07162922).