Sevoflurane With or Without Intravenous Lidocaine Infusion Versus Propofol Anesthesia on Intracranial Pressure and Cerebral Oxygenation During Laparoscopic Hysterectomy

Effect of Sevoflurane With or Without Intravenous Lidocaine Infusion Versus Propofol Anesthesia on Intracranial Pressure and Cerebral Oxygenation During Laparoscopic Hysterectomy: A Randomized Controlled Study

This study will be conducted to evaluate the effects of different anesthetic modalities [sevoflurane with or without intraoperative lidocaine infusion and Propofol total intravenous anesthesia (TIVA)] on intracranial pressure (ICP) and cerebral oxygenation assessed by non-invasive methods during laparoscopic hysterectomy (LH).

Laparoscopic hysterectomy (LH) requires a Trendelenburg position (TP) and the creation of an artificial pneumoperitoneum (PP) by carbon dioxide insufflation.

Various studies were done to evaluate the effects of different anesthesia techniques on intracranial pressure (ICP) during LH, and most of these studies revealed that propofol total intravenous anesthesia (TIVA) was superior to inhaled anesthesia regarding reduction of ICP (ONSD).

Inclusion Criteria:

• Age from 18 to 65 years.
• American Society of Anesthesiologists (ASA) physical status I and Ⅱ.
• Body mass index (BMI) ≤35.
• Females scheduled for laparoscopic hysterectomy.

Exclusion Criteria:

• Patients' refusal to participate in the study.
• Hypersensitivity and allergy to drugs of the study.
• Contraindication for optic nerve sheath diameter assessment. E.g., patient with pre-existing ophthalmic diseases, a history of ophthalmic surgery
• Any central nervous system or cardiovascular disease, severe hepatic or renal impairment
• Intraoperative circumstances, such as inability to perform optic nerve sheath diameter or conversion to open surgery
• If peak inspiratory pressure (PIP) exceeds 35.