Comparison of the effects of total intravenous anesthesia and inhalational anesthesia on intracranial pressure with ultrasonographic measurement of optic nerve sheath diameter during laparoscopic surgery under different endtidal carbondioxide value

Laparoscopic surgery is less invasive compared to open surgery, there is less risk of hemorrhage, and patients have the possibility of earlier discharge. In this study, we investigated the effect of total intravenous anesthesia and inhalation anesthesia on ultrasonographic optic nerve sheath diameter measurement in intracranial pressure in different endtidal carbon dioxide values in laparoscopic surgery. In the study, HR, SBP, DBP, MBP, etCO2, SpO2, ONSD, PPEAK, PPLATO, HEAT, ONSD / ETD and ETD values were recorded in 5 time periods and then analyzed. In our study, 4 groups were created and the difference between them was examined. The effects of propofol and sevoflurane anesthesia methods and different endtidal carbon dioxide pressures on intracranial pressure were investigated. According to the examinations, it was determined that there was no significant difference between the four groups in SBP, DBP, MBP, SpO2, PPEAK, PPLATO and ETD values. A significant difference was found for the HR value only in the T1 timeframe. There was a significant difference between the groups for T0, T1, T2, T3 and T4 in etCO2, HEAT and ONSD / ETD values. There was no difference in ONSD for T0 and T1, and statistically significant differences were found between the groups for T2, T3 and T4 times. As a result, we determined that pneumoperitoneum applied in laparoscopic cholecystectomies increased the optic nerve sheath diameter, the duration of pneumoperitoneum was correlated with the increase of optic nerve sheath diameter, and in these anesthesia management, the increase in the optic nerve sheath diameter could be limited by using TIVA instead of volatile anesthetics and keeping etCO2 around 30 mmHg. . Although this pressure increase is largely insignificant in healthy people, anesthesia technique should be carefully selected in laparoscopic surgeries in patients with intracranial pathology or increased risk of decreased cerebral perfusion and values with intracranial effects such as etCO2 levels should be carefully monitored.