The Effect of Pneumoperitoneum Timing on Intracranial Pressure in Laparoscopy

NCT ID: NCT04224532

Last Updated: 2020-06-04

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

79 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-01-08

Study Completion Date

2020-03-01

Brief Summary

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Reverse Trendelenburg position has been shown to slightly reduce the intracranial pressure associated with pneumoperitoneum. However, there are no studies on the effect of the timing of reverse Trendelenburg position on intracranial pressure. This study will monitor the effect of reverse Trendelenburg position before or after pneumoperitoneum on intracranial pressure and regional cerebral oxygen saturation.

Detailed Description

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The literature includes studies that investigate the relationship of pneumoperitoneum and different positions with intracranial pressure during laparoscopy. Reverse Trendelenburg position has been shown to slightly reduce the intracranial pressure associated with pneumoperitoneum. However, there are no studies on the effect of the timing of reverse Trendelenburg position on intracranial pressure. This study will monitor the effect of reverse Trendelenburg position before or after pneumoperitoneum on intracranial pressure and regional cerebral oxygen saturation. Ultrasound guided measurement of the optic nerve sheath diameter as a non-invasive method will be used for measurement. The investigators believe reverse Trendelenburg position before pneumoperitoneum may prevent undesired sudden increases in intracranial pressure.

Conditions

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Intracranial Pressure Increase Pneumoperitoneum

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors

Study Groups

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Group P

Pneumoperitoneum is induced before reverse Trendelenburg position.

Group Type EXPERIMENTAL

Pneumoperitoneum Timing (Before Positioning)

Intervention Type PROCEDURE

Before Reverse Trendelenburg Position

Group RT

Pneumoperitoneum is induced after reverse Trendelenburg position.

Group Type EXPERIMENTAL

Pneumoperitoneum Timing (After Positioning)

Intervention Type PROCEDURE

After Reverse Trendelenburg Position

Interventions

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Pneumoperitoneum Timing (Before Positioning)

Before Reverse Trendelenburg Position

Intervention Type PROCEDURE

Pneumoperitoneum Timing (After Positioning)

After Reverse Trendelenburg Position

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Undergoing laparoscopic cholecystectomy operation
* Age between 18-65
* ASA I-II
* BMI ≤ 35

Exclusion Criteria

* Ophthalmologic disease and optic nerve pathology
* Increased intracranial pressure
* History of cerebrovascular disease
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Bagcilar Training and Research Hospital

OTHER_GOV

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Serdar Demirgan, MD

Role: PRINCIPAL_INVESTIGATOR

Bagcilar Training and Research Hospital

Locations

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Bagcilar Training and Research Hospital

Istanbul, , Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

References

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Robba C, Cardim D, Donnelly J, Bertuccio A, Bacigaluppi S, Bragazzi N, Cabella B, Liu X, Matta B, Lattuada M, Czosnyka M. Effects of pneumoperitoneum and Trendelenburg position on intracranial pressure assessed using different non-invasive methods. Br J Anaesth. 2016 Dec;117(6):783-791. doi: 10.1093/bja/aew356.

Reference Type BACKGROUND
PMID: 27956677 (View on PubMed)

Dip F, Nguyen D, Rosales A, Sasson M, Lo Menzo E, Szomstein S, Rosenthal R. Impact of controlled intraabdominal pressure on the optic nerve sheath diameter during laparoscopic procedures. Surg Endosc. 2016 Jan;30(1):44-9. doi: 10.1007/s00464-015-4159-0. Epub 2015 Apr 22.

Reference Type BACKGROUND
PMID: 25899811 (View on PubMed)

Sahay N, Sharma S, Bhadani UK, Singh A, Sinha C, Sahay A, Ranjan A, Agarwal M. Effect of Pneumoperitoneum and Patient Positioning on Intracranial Pressures during Laparoscopy: A Prospective Comparative Study. J Minim Invasive Gynecol. 2018 Jan;25(1):147-152. doi: 10.1016/j.jmig.2017.07.031. Epub 2017 Sep 12.

Reference Type BACKGROUND
PMID: 28918894 (View on PubMed)

Demirgan S, Ozcan FG, Gemici EK, Guneyli HC, Yavuz E, Gulcicek OB, Selcan A. Reverse Trendelenburg position applied prior to pneumoperitoneum prevents excessive increase in optic nerve sheath diameter in laparoscopic cholecystectomy: randomized controlled trial. J Clin Monit Comput. 2021 Feb;35(1):89-99. doi: 10.1007/s10877-020-00608-6. Epub 2020 Oct 21.

Reference Type DERIVED
PMID: 33089454 (View on PubMed)

Other Identifiers

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2019.10.103.072

Identifier Type: -

Identifier Source: org_study_id

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