Cargando…

Change in the optic nerve sheath diameter after deflation of a pneumatic tourniquet: a prospective observational study

Applying a pneumatic tourniquet provides surgeons with a bloodless surgical field. However, application of the tourniquet induces various physiological changes. We evaluated the effect of tourniquet deflation on the intracranial pressure by using ultrasonography to measure the optic nerve sheath dia...

Descripción completa

Detalles Bibliográficos
Autores principales: Kim, Ha-Jung, Kim, Yeon Ju, Kim, Jiyoung, Kim, Hyungtae, Ro, Young-Jin, Koh, Won Uk
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8752803/
https://www.ncbi.nlm.nih.gov/pubmed/35017581
http://dx.doi.org/10.1038/s41598-021-04457-4
_version_ 1784631953634361344
author Kim, Ha-Jung
Kim, Yeon Ju
Kim, Jiyoung
Kim, Hyungtae
Ro, Young-Jin
Koh, Won Uk
author_facet Kim, Ha-Jung
Kim, Yeon Ju
Kim, Jiyoung
Kim, Hyungtae
Ro, Young-Jin
Koh, Won Uk
author_sort Kim, Ha-Jung
collection PubMed
description Applying a pneumatic tourniquet provides surgeons with a bloodless surgical field. However, application of the tourniquet induces various physiological changes. We evaluated the effect of tourniquet deflation on the intracranial pressure by using ultrasonography to measure the optic nerve sheath diameter (ONSD) in patients undergoing lower limb surgery. The ONSD was measured in 20 patients at five time points: after anesthetic induction (T0) and immediately before (T1), immediately after (T2), 5 min after (T3), and 10 min after tourniquet deflation (T4). Hemodynamic and respiratory variables were recorded. The ONSD showed significant differences at each point (P < 0.001). The ONSDs at T2 and T3 were significantly greater than that at T1 (P = 0.0007 and < 0.0001, respectively). The change in the end-tidal carbon dioxide partial pressure (EtCO2) was similar to the change in the ONSD. The change in the ONSD was significantly correlated with the change in the EtCO2 after tourniquet deflation (r = 0.484, P = 0.030). In conclusion, the ONSD, as an indicator of intracranial pressure, increased after tourniquet deflation in patients undergoing lower limb surgery. This was correlated with an increased EtCO2 and arterial carbon dioxide partial pressure. Trial registration: ClinicalTrials.gov (NCT03782077).
format Online
Article
Text
id pubmed-8752803
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Nature Publishing Group UK
record_format MEDLINE/PubMed
spelling pubmed-87528032022-01-13 Change in the optic nerve sheath diameter after deflation of a pneumatic tourniquet: a prospective observational study Kim, Ha-Jung Kim, Yeon Ju Kim, Jiyoung Kim, Hyungtae Ro, Young-Jin Koh, Won Uk Sci Rep Article Applying a pneumatic tourniquet provides surgeons with a bloodless surgical field. However, application of the tourniquet induces various physiological changes. We evaluated the effect of tourniquet deflation on the intracranial pressure by using ultrasonography to measure the optic nerve sheath diameter (ONSD) in patients undergoing lower limb surgery. The ONSD was measured in 20 patients at five time points: after anesthetic induction (T0) and immediately before (T1), immediately after (T2), 5 min after (T3), and 10 min after tourniquet deflation (T4). Hemodynamic and respiratory variables were recorded. The ONSD showed significant differences at each point (P < 0.001). The ONSDs at T2 and T3 were significantly greater than that at T1 (P = 0.0007 and < 0.0001, respectively). The change in the end-tidal carbon dioxide partial pressure (EtCO2) was similar to the change in the ONSD. The change in the ONSD was significantly correlated with the change in the EtCO2 after tourniquet deflation (r = 0.484, P = 0.030). In conclusion, the ONSD, as an indicator of intracranial pressure, increased after tourniquet deflation in patients undergoing lower limb surgery. This was correlated with an increased EtCO2 and arterial carbon dioxide partial pressure. Trial registration: ClinicalTrials.gov (NCT03782077). Nature Publishing Group UK 2022-01-11 /pmc/articles/PMC8752803/ /pubmed/35017581 http://dx.doi.org/10.1038/s41598-021-04457-4 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Kim, Ha-Jung
Kim, Yeon Ju
Kim, Jiyoung
Kim, Hyungtae
Ro, Young-Jin
Koh, Won Uk
Change in the optic nerve sheath diameter after deflation of a pneumatic tourniquet: a prospective observational study
title Change in the optic nerve sheath diameter after deflation of a pneumatic tourniquet: a prospective observational study
title_full Change in the optic nerve sheath diameter after deflation of a pneumatic tourniquet: a prospective observational study
title_fullStr Change in the optic nerve sheath diameter after deflation of a pneumatic tourniquet: a prospective observational study
title_full_unstemmed Change in the optic nerve sheath diameter after deflation of a pneumatic tourniquet: a prospective observational study
title_short Change in the optic nerve sheath diameter after deflation of a pneumatic tourniquet: a prospective observational study
title_sort change in the optic nerve sheath diameter after deflation of a pneumatic tourniquet: a prospective observational study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8752803/
https://www.ncbi.nlm.nih.gov/pubmed/35017581
http://dx.doi.org/10.1038/s41598-021-04457-4
work_keys_str_mv AT kimhajung changeintheopticnervesheathdiameterafterdeflationofapneumatictourniquetaprospectiveobservationalstudy
AT kimyeonju changeintheopticnervesheathdiameterafterdeflationofapneumatictourniquetaprospectiveobservationalstudy
AT kimjiyoung changeintheopticnervesheathdiameterafterdeflationofapneumatictourniquetaprospectiveobservationalstudy
AT kimhyungtae changeintheopticnervesheathdiameterafterdeflationofapneumatictourniquetaprospectiveobservationalstudy
AT royoungjin changeintheopticnervesheathdiameterafterdeflationofapneumatictourniquetaprospectiveobservationalstudy
AT kohwonuk changeintheopticnervesheathdiameterafterdeflationofapneumatictourniquetaprospectiveobservationalstudy