The Effect Of Positive End-Expiratory Pressure on Optic Nerve Sheath Diameter In Pediatric Patients Undergoing Craniotomy in Supine Position
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 30
- 试验地点
- 1
- 主要终点
- optic nerve sheath diameter
研究概览
简要总结
This study evaluated the effect of positive end-expiratory pressure (PEEP) on optic nerve sheath diameter (ONSD), an indicator of intracranial pressure, in pediatric patients undergoing craniotomy in the supine position. The findings indicated that the application of PEEP did not result in a significant difference in ONSD. Although a significant decrease in systolic and diastolic blood pressure was observed with the use of PEEP, these values remained within normal ranges and did not indicate adverse hemodynamic effects. The results suggest that the use of a PEEP level of 4 cmH2O in pediatric patients with intracranial masses is safe and may be applied during the perioperative period.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- Single (Investigator)
入排标准
- 年龄范围
- 6 Months 至 18 Years（Child, Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Pediatric patients aged 6 months to 18 years
- •American Society of Anesthesiologists (ASA) physical status III
- •Scheduled for elective craniotomy in the supine position
- •Presence of an extra-axial intracranial mass
- •Written informed consent obtained from parents or legal guardians
排除标准
- •Open fontanelles
- •Orbital pathology
- •Severe increases in intracranial pressure associated with nausea, vomiting, visual disturbances, or seizures
- •Radiologic or clinical signs of brain herniation
- •Hydrocephalus
- •Cerebral infection
- •Congenital syndromes
- •History of surgery involving the optic nerve
- •Use of inotropic therapy
- •Hemodynamic instability
- •Surgical complications during the operation or procedures lasting longer than 8 hours
- •Postoperative intubation requiring intensive care unit follow-up
- •Tumors invading the optic nerve
- •Inability to obtain written informed consent from parents or legal guardians
研究组 & 干预措施
Study Group
PEEP 4 group
干预措施: General Anesthesia (Drug)
Study Group
PEEP 4 group
干预措施: Anesthetic Agents (Drug)
Study Group
PEEP 4 group
干预措施: mechanical ventilation (MV) (Device)
Control Group
PEEP 0 Group
干预措施: General Anesthesia (Drug)
Control Group
PEEP 0 Group
干预措施: Anesthetic Agents (Drug)
Control Group
PEEP 0 Group
干预措施: mechanical ventilation (MV) (Device)
结局指标
主要结局
optic nerve sheath diameter
时间窗: Four times in during the operation by using ultrasonography. T0: before induction of anesthesia; T1: immediately after the dura was opened; T2: just before the dura was closed; T3: before extubation
次要结局
- Heart Rate(Four times in during the operation. T0: before induction of anesthesia; T1: immediately after the dura was opened; T2: just before the dura was closed; T3: before extubation)
- systolic blood pressure(Four times in during the operation. T0: before induction of anesthesia; T1: immediately after the dura was opened; T2: just before the dura was closed; T3: before extubation)
- diastolic blood pressure(Four times in during the operation. T0: before induction of anesthesia; T1: immediately after the dura was opened; T2: just before the dura was closed; T3: before extubation)
- Peripheral oxygen saturation(Four times in during the operation. T0: before induction of anesthesia; T1: immediately after the dura was opened; T2: just before the dura was closed; T3: before extubation)
研究者
Eren Karahan
Md
Dr. Lutfi Kirdar Kartal Training and Research Hospital