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Effect of Carbon Dioxide Pressure on Optic Nerve Sheath Diameter in Laparoscopic Transperitoneal Nephrectomy

NCT07262125 · Status: ENROLLING_BY_INVITATION · Phase: NA · Type: INTERVENTIONAL · Enrollment: 100

Last updated 2025-12-03

No results posted yet for this study

Summary

Nephrectomy is a surgical procedure performed for various indications, and with the development and increasing availability of advanced diagnostic techniques, its incidence has been rising. Today, in appropriate cases, laparoscopic surgery is recommended due to its minimally invasive nature and its surgical success rates being comparable to those of open surgery. In laparoscopic surgery, to achieve optimal visualization, a 45° lateral decubitus position is applied, followed by the creation of a pneumoperitoneum using carbon dioxide gas. While the cardiopulmonary effects of this procedure have been shown to be minimal, studies on its intracranial effects are limited. Cerebral perfusion pressure is defined as the difference between mean arterial pressure and either central venous pressure or intracranial pressure, whichever is higher. Intracranial pressure can be assessed non-invasively using ultrasonographic measurement of the Optic Nerve Sheath Diameter (ONSD). The retrobulbar segment of the optic nerve is surrounded by a distensible subarachnoid space, which expands in response to increased intracranial pressure. The effect of increased intra-abdominal pressure during laparoscopic surgery on intracranial pressure, and its impact on ONSD, will be evaluated non-invasively.

In patients scheduled for laparoscopic kidney surgery, the Optic Nerve Sheath Diameter will be measured transorbitally using ultrasonography by the investigator at various stages of the surgery (before anesthesia, after anesthesia, in the lateral decubitus position, during pneumoperitoneum, and at routine intraoperative pressure levels). Additionally, standard monitoring parameters such as pulse rate, blood pressure, oxygen saturation, and End-Tidal CO₂ will be recorded. The Optic Nerve Sheath Diameter, which serves as an indicator of increased intracranial pressure, will be compared with variables such as surgical positioning, BMI, ASA score, and other relevant factors.

Conditions

  • Optic Nerve Sheath Diameter
  • Laparoscopic Nephrectomy

Interventions

DIAGNOSTIC_TEST

Optic Nerve Sheath Diameter Measurement

Optic Nerve Sheath Diameter Measurement, Oxygen saturation and End Tidal CO2 measurements when Pre-operational Supine position, after intubation, Lateral decubitus position, after Pneumoperitoneum, CO2 pressure level at 14-16-18-20 and Post-operational supine position

Sponsors & Collaborators

  • Fatih Sultan Mehmet Training and Research Hospital

    lead OTHER

Study Design

Allocation
NA
Purpose
BASIC_SCIENCE
Masking
NONE
Model
SINGLE_GROUP

Eligibility

Min Age
31 Years
Max Age
69 Years
Sex
ALL
Healthy Volunteers
No

Timeline & Regulatory

Start
2024-12-01
Primary Completion
2025-12-01
Completion
2026-01-01

Countries

  • Turkey (Türkiye)

Study Locations

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Read the full study record

This page highlights key information. For complete eligibility criteria, study locations, investigator contacts, and the full protocol, visit the original record on ClinicalTrials.gov.

View NCT07262125 on ClinicalTrials.gov