The aim of this study is to evaluate the effects of different carbon dioxide gas insufflation pressures on the ultrasound-guided optic nerve sheath diameter in patients undergoing laparoscopic cholecystectomy and to determine the possible relationship between these changes and intracranial pressure. The study aims to gain a better understanding of the neurophysiological effects of gas pressures used during laparoscopic surgery and to obtain scientific data aimed at improving patient safety.
Patients aged between 18 and 80 years.
Patients scheduled for laparoscopic cholecystectomy.
ASA (American Society of Anesthesiologists) physical status I or II.
History of intracranial space-occupying lesion or high intracranial pressure (ICP).
History of abdominal trauma.
History of orbital/ocular trauma.
The study population consists of adult patients aged 18-80 years, classified as ASA I-II physical status, who are scheduled to undergo elective laparoscopic cholecystectomy in a tertiary care hospital setting. Patients are observed within the routine clinical workflow of the anesthesia and general surgery departments.
Cohort
Prospective
Low Pressure Group
Procedure/SurgeryData will be collected on patients who underwent surgery within a pressure range of 10-14, depending on the surgeon's preference.
High Pressure Group
Procedure/SurgeryData will be collected on patients who underwent surgery within a pressure range of 14-18, depending on the surgeon's preference.
ONSD/ETD
Optic nerve sheath diameter (ONSD) eyeball transverse diameter (ETD) ratio: The ONSD/ETD ratio will be calculated by dividing the mean ONSD value by the mean ETD value for each participant. This dimensionless ratio will be utilized as a standardized surrogate marker to evaluate changes in intracranial pressure (ICP), effectively minimizing confounding individual variations in eyeball size and ocular anatomy
ONSD
Optic Nerve Sheat Diameter during surgery: Optic nerve sheath diameter (ONSD) will be evaluated using high-resolution transbulbar ultrasonography to monitor real-time changes in intracranial pressure during the surgical procedure. A linear ultrasound probe will be placed gently over the closed eyelid using acoustic gel, ensuring minimal pressure on the globe.ONSD measurements will be performed bilaterally at a depth of 3 mm posterior to the retina, perpendicular to the optic nerve axis. The mean value of three consecutive measurements from each eye will be recorded for analysis.
MAP
Recording Measurement of Mean Arterial Pressure (MAP) in mmHg during surgery
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