Ultrasonographic Assessment of Optic Nerve Sheath Diameter during Pediatric Laparoscopy

• Published in: Ultrasound in medicine & biology Vol. 41; no. 5; pp. 1241 - 1246
• Main Authors: Min, Ji Young, Lee, Jeong-Rim, Oh, Jung-Tak, Kim, Min-Soo, Jun, Eun-Kyung, An, Jiwon
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 01-05-2015
• Subjects: Child; Child, Preschool; Female; Humans; Image Interpretation, Computer-Assisted - methods; Infant; Infant, Newborn; Intracranial Hypertension - diagnostic imaging; Laparoscopy - methods; Male; Monitoring, Intraoperative - methods; Optic Nerve - diagnostic imaging; Optic nerve sheath; Pediatric laparoscopy; Radiology; Reproducibility of Results; Sensitivity and Specificity; Surgery, Computer-Assisted - methods; Ultrasonography, Doppler, Transcranial - methods; Ultrasound; Optic nerve sheath; Ultrasound; Pediatric laparoscopy
• ISSN: 0301-5629; 1879-291X
• DOI: 10.1016/j.ultrasmedbio.2015.01.009

Abstract This study investigated the extent of the raised intracranial pressure resulting from carbon dioxide (CO2 ) pneumoperitoneum by ultrasonographically measuring optic nerve sheath diameter (ONSD) in children undergoing laparoscopic surgery. Twenty-five children aged less than 9 y (53.1 ± 23.3 mo, mean ± standard deviation) and scheduled for an elective laparoscopic surgery participated. ONSD was assessed using ocular ultrasonography 10 min after induction of anesthesia (T0), 10 min after induction of CO2 pneumoperitoneum at 10 mm Hg intra-abdominal pressure (T1) and in an anesthetized state without CO2 pneumoperitoneum at the conclusion of the surgery (T2). During CO2 pneumoperitoneum, ONSD increased significantly compared with ONSD after anesthesia induction (T0: 4.3 ± 0.3 mm, T1: 4.6 ± 0.3 mm, p  < 0.05). In all enrolled patients, any neurologic complications were not observed during the intra-operative or post-operative period. In children undergoing laparoscopic surgery, an increase in ONSD was ascertained during CO2 pneumoperitoneum, and thus the corresponding increase in intracranial pressure could be predicted.