Evaluation of optic nerve sheath diameter measurement with the effect of LMA supreme, baska mask LMA and endotracheal intubation on intracranial pressure in gynecological laparoscopic operations

Evaluation of optic nerve sheath diameter measurement with the effect of LMA Supreme, Baska Mask LMA and endotracheal intubation on intracranial pressure in gynecological laparoscopic operations While endotracheal intubation was the only way to safely provide airway patency in surgical procedures until 1981, the classic laryngeal mask (LMA)which is the first supraglotic airway device manufactured by Archie Brain was introduced. It started to be used in order to provide a safe and effective airway (1). LMA, which has been used successfully and safely for many years in anesthesia application, has also been used successfully in gynecological laparoscopic operations (2-4). In this study, we aimed to evaluate the effect of intracranial pressure on intracranial pressure by measuring the optic nerve sheath diameter and to show its change in laparoscopic gynecological operations in time. 60 female patients aged between 18 and 65 who are going to undergo an gynecologic laparoscopic operation with general anesthesia in the operating room of BAIBU Izzet Baysal Training and Research Hospital were included to the study, after obtaining the written consent of the ethics committee and patients. These 60 female patients were also in ASA I-III physical status.The patients were divided into 3 groups as double blind withrandomized method, prospective method and closed envelope method .These three groups are endotracheal tube, Baska Mask LMA and LMA Supreme. The first measurement will be made in the supine position before general anesthesia (T0). Afterwards, general anesthesia induction will be madeby the anesthetist. During anesthesia induction,blackout and muscle relaxation will be achieved by using propofol (2mg / kg), fentanyl (1-2 mcg / kg), rocuronium (0.6mg / kg) as IV. Optic nerve sheath diameter measurements before induction (T0), 1 minute after induction (T1), 1 minute after intubation (T2), 3 minutes after intubation (T3), 10 minutes after pneumoperitonium and trendelenburg position (T4), 30 minutes after pneumoperitonium and trendelenburg position (T5) before extubation (T6) values will be recorded.In terms of demographic characteristics and clinical characteristics, there is no statistically significant difference between the groups (p>0.05). Statistically significant difference isnotfound between the groups in terms of ONSD measurements. (P> 0.05). In-group evaluation of ONSD in these three different groups, change of ONSD in timewas examined (Table 4.7.) There isno statistically significant difference according tothe pre-induction ONSD values, 1st minute after intubation and 3rd minute after intubation (p> 0.05). 10th minute after pneumoperitonium and trendelenburg position, 30th minute after Pneumoperitonium and trendelenburg position; it isobserved that it is statistically higher than the time before induction, 1 minute after induction, 1 minute after intubation, 3 minutes after intubation and before extubation (p = 0.01, p <0.05). As a result we found that there is no significant relationship between ONSD and intubation & LMA insertion. ONSD is not significantly increased due to the intubation and LMA insertion.