Related Experiment Videos
Changes in intracranial pressure associated with apneumic retractors
J R Este-McDonald1, L G Josephs, D H Birkett
1Department of Surgery, Boston University Medical Center, Mass, USA.
Archives of Surgery (Chicago, Ill. : 1960)
|April 1, 1995
Summary
Pneumoperitoneum increases intracranial pressure (ICP), but apneumic retraction does not. Apneumic retraction may be a safer laparoscopic option for patients with elevated ICP.
Area of Science:
- Neurosurgery
- Surgical Innovation
- Physiology
Background:
- Elevated intracranial pressure (ICP) poses significant risks during surgical procedures.
- Laparoscopic surgery often involves pneumoperitoneum, which can affect ICP.
- Alternative retraction methods are needed to ensure patient safety in neurosurgical contexts.
Purpose of the Study:
- To evaluate the impact of apneumic retraction on ICP in a live animal model.
- To compare the effects of pneumoperitoneum versus apneumic retraction on ICP.
- To assess the safety of apneumic retraction in the context of elevated ICP.
Main Methods:
- A live porcine model was utilized with induced elevated ICP via an epidural balloon.
- Intracranial pressure (ICP), mean arterial pressure, and blood gas levels were monitored.
- Measurements were taken before, during, and after pneumoperitoneum and apneumic retraction.
Main Results:
- Pneumoperitoneum significantly increased ICP in both non-injured and head-injured models (P = .0001).
- Apneumic anterior wall retraction, equivalent to 20 mm Hg, did not alter ICP.
- These findings were independent of changes in arterial PCO2 or pH.
Conclusions:
- Pneumoperitoneum adversely affects ICP and should be used cautiously in patients with elevated ICP.
- Apneumic retraction appears to be a safe alternative for laparoscopic evaluation in patients with raised ICP.
- Further investigation into apneumic retraction could lead to safer laparoscopic procedures in neurosurgery.