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腹腔镜手术对儿童视神经外直径 (ONSD) 的影响

Mohsina Yasmeen¹, Sumaiya Sabreen¹, Akshay Bettanayaka¹

¹Department of Anesthesiology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India.

Saudi journal of anaesthesia

|February 17, 2025

概括

超声波测量视神经外直径 (ONSD) 可以在腹腔镜手术期间检测增加的内压力 (ICP). 这种非侵入性方法可靠地监测患者的安全性和麻醉管理.

科学领域:

麻醉学麻醉学
神经外科神经外科
儿科手术儿科手术

背景情况:

用肺皮管进行 laparoscopic 手术会增加内压力 (ICP).
特伦德伦堡的立场进一步加剧了ICP的上升.
光神经外直径 (ONSD) 超声波提供了一种非侵入性,可靠的方法来检测升高的ICP.

研究的目的:

评估通过超声波测量视神经外直径 (ONSD) 的实用性,用于进行腹腔镜手术的儿科患者.
评估肺上皮与ONSD变化之间的相关性,作为内压力 (ICP) 的指标.

主要方法:

一项前性观察性研究,涉及23名儿科患者 (5-16岁) 接受选择性腹腔镜手术.
基线ONSD测量使用眼睛超声波在肺膜前.
在确定肺上皮膜在12cmH2O的腹内压力 (IAP) 后15分钟后重新测量了ONSD.

主要成果:

与基线值 (P < 0.016) 相比,在肺上皮下后的两只眼睛中观察到ONSD的统计学上显著增加.
平均ONSD读数仍低于5毫米的切割线,表明ICP增加.
在研究参数中,没有在统计学上显著的ICP上升,正如ONSD指出的那样.

结论:

超声波导向的ONSD测量是监测腹腔镜手术期间ICP的一个有价值的工具.
这种技术有助于保持最佳的腹内压力,并确保安全的麻醉管理.
它对于易受ICP波动的儿科患者特别有用.

关键词:

内压力内压力视神经的视觉神经是如何工作的气皮 (pneumoperitoneum) 是一种用于呼吸的药物

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