The Importance of Perioperative Optic Nerve Sheath Diameter Measurement by Ultrasonography in Cranial Surgery Cases and Its Contribution to Patient Safety
Project no. 20878 · Status: Kapanmış (Yayın bekleniyor) · 2019
Summary
OBJECTIVE: In cranial surgery cases, intracranial pressure (ICP) may increase due to cerebral ischemia and surgical exclusion. Early recognition and treatment of this pressure increase is vital. Intracranial pressure can be measured with invasive or non-invasive methods. Non-invasive methods; These are indirect findings with computed tomography, magnetic resonance imaging (MRI), and ultrasound (USG). Optic nerve sheath diameter (ONSD) measurement by USG is a cheap, easily accessible method with a low complication risk compared to other techniques. Our main aim is to detect the increase in intracranial pressure in the early period by measuring the ONSD of the patients with bedside ultrasound and to guide the treatment of the patients early.In our study, we aimed to observe the reliability of US measurement by comparing preoperative and postoperative US and MR ONSD measurements. MATERIALS-METHOD: A prospective observational study was contucted among 27 patients undergoing ıntracranial tumor surgery. The ONSD of each patient has been measured by USG and MRI scan both before and after the surgery. All the ONSD measurements via USG have been conducted by the same anesthesiology and rehabilitation spealist and MR scans have been conducted by the same neurosurgeon.The difference in the pre-operative and post-operative ONSD measurement was analyzed using a paired t-test. RESULTS: A total of 27 cases between the ages of 18 – 65 (46,7±14,5 years) have been enrolled in our study. The gender distribution was quite even 55.6% (n=15) of them were women and %44.4 (n=12) of them were male. The mean duration of surgery was 202.2?56.9 hours and the mean time to discharge was 5.04?1.7 days. Preoperative and postoperative USG and MRI measurements were not found to be compatible with each other. CONCLUSION: In this study, we could not find a statistical correlation between USG and MR and ONSD measurement. We could not prove the reliability of the bedside ultrasound measurement of ONSD for monitoring intracranial pressure rise.