Comparison of Propofol and Propofol-Ketamine Anesthesia on Optic Nerve Sheath Diameter in Endovascular Cerebral Aneurysm Procedures
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 46
- 试验地点
- 1
- 主要终点
- Change in Optic Nerve Sheath Diameter (ONSD)
研究概览
简要总结
This study aimed to compare the effects of propofol-based anesthesia and propofol-ketamine anesthesia on optic nerve sheath diameter (ONSD) in patients undergoing elective endovascular treatment of unruptured intracranial aneurysms. ONSD, measured using ultrasonography, is a non-invasive surrogate marker of intracranial pressure. In addition, intraoperative hemodynamic parameters, cerebral oxygenation, and anesthetic requirements were evaluated to assess the safety and physiological impact of the two anesthesia techniques.
详细描述
Endovascular treatment of unruptured intracranial aneurysms requires anesthetic strategies that maintain cerebral perfusion and hemodynamic stability while minimizing increases in intracranial pressure. Optic nerve sheath diameter (ONSD) measurement using ultrasonography is a widely accepted non-invasive method for assessing intracranial pressure changes.
This study included adult patients who underwent elective endovascular treatment for unruptured intracranial aneurysms. Patients were managed with either propofol-based anesthesia or a combination of propofol and ketamine according to routine clinical practice.
ONSD measurements were performed at predefined time points during the perioperative period, and changes in ONSD were analyzed. In addition, intraoperative mean arterial pressure, heart rate, end-tidal carbon dioxide levels, regional cerebral oxygen saturation, vasopressor requirements, and total anesthetic consumption were recorded.
The primary objective of the study was to compare changes in ONSD between the two anesthesia techniques. Secondary objectives included evaluation of hemodynamic stability, cerebral oxygenation, and anesthetic requirements.
研究设计
- 研究类型
- Observational
- 观察模型
- Other
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 18 Years 至 75 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age between 18 and 75 years
- •Patients scheduled for elective endovascular treatment of unruptured intracranial aneurysms
- •ASA physical status I-III
- •Glasgow Coma Scale score of 15
- •Ability to read and write and provide written informed consent
排除标准
- •Age under 18 or over 75 years
- •ASA physical status IV or higher
- •History of ocular disease or previous eye surgery
- •Presence of giant aneurysm
- •Increased intracranial pressure
- •Coronary artery disease
- •Psychiatric or neurological disorders interfering with consent or assessment
- •Emergency surgical indication
研究组 & 干预措施
Propofol Anesthesia
Patients who underwent elective endovascular treatment of unruptured intracranial aneurysms under propofol-based general anesthesia
干预措施: Propofol (Astra-Zeneca) (Drug)
Propofol-Ketamine Anesthesia
Patients who underwent elective endovascular treatment of unruptured intracranial aneurysms under general anesthesia with a combination of propofol and ketamine
干预措施: Propofol and Ketamine Mixture (Ketofol) (Drug)
结局指标
主要结局
Change in Optic Nerve Sheath Diameter (ONSD)
时间窗: From pre-induction (baseline) to end of procedure
Optic nerve sheath diameter (ONSD) was measured using ultrasonography at five predefined time points: pre-induction (baseline), pre-intubation, post-intubation, end of procedure, and recovery period. The primary outcome was the change in ONSD from baseline to the end of the procedure. Measurements were obtained bilaterally at 3 mm behind the globe and averaged.
次要结局
- Mean Arterial Pressure (MAP)(Mean arterial pressure was recorded at predefined time points, including pre-induction, intraoperative period at 5-minute intervals, and recovery.)
- Heart Rate(Heart rate was recorded at predefined time points, including pre-induction, intraoperative period at 5-minute intervals, and recovery.)
- EtCO₂(End-tidal carbon dioxide levels were measured at predefined time points, including intraoperative period at 5-minute intervals.)
- rSO₂(Regional cerebral oxygen saturation values were monitored continuously and recorded at predefined time points, including intraoperative period at 5-minute intervals.)
- Bispectral Index (BIS)(Bispectral index values were recorded to monitor depth of anesthesia at predefined time points, including pre-induction, intraoperative period at 5-minute intervals, and recovery.)
研究者
Eda Şahin
Resident Physician in Anesthesiology
Ankara City Hospital Bilkent