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This study evaluated the effect of positive end-expiratory pressure (PEEP) on optic nerve sheath diameter (ONSD), an indicator of intracranial pressure, in pediatric patients undergoing craniotomy in the supine position. The findings indicated that the application of PEEP did not result in a significant difference in ONSD. Although a significant decrease in systolic and diastolic blood pressure was observed with the use of PEEP, these values remained within normal ranges and did not indicate adverse hemodynamic effects. The results suggest that the use of a PEEP level of 4 cmH2O in pediatric patients with intracranial masses is safe and may be applied during the perioperative period.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Study Group | Active Comparator | PEEP 4 group |
|
| Control Group | Active Comparator | PEEP 0 Group |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| General Anesthesia | Drug | General anesthesia was administered according to standard clinical practice, including intravenous induction agents and inhalational anesthetics, as part of routine perioperative care. |
| Measure | Description | Time Frame |
|---|---|---|
| optic nerve sheath diameter | Four times in during the operation by using ultrasonography. T0: before induction of anesthesia; T1: immediately after the dura was opened; T2: just before the dura was closed; T3: before extubation |
| Measure | Description | Time Frame |
|---|---|---|
| Heart Rate | Four times in during the operation. T0: before induction of anesthesia; T1: immediately after the dura was opened; T2: just before the dura was closed; T3: before extubation | |
| systolic blood pressure | Four times in during the operation. T0: before induction of anesthesia; T1: immediately after the dura was opened; T2: just before the dura was closed; T3: before extubation |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Dr Lutfi Kırdar City Hospital | Istanbul | eyüpsultan | 34077 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| Background | Sezen O, Saracoglu KT, Simsek T, Cevik B, Aydogmus E. The effect of positive end-expiratory pressure on optic nerve diameter in patients undergoing craniotomy operation. Ann Clin Anal Med. 2021;12(02):199-203. | ||
| 23519374 | Background | Pulitano S, Mancino A, Pietrini D, Piastra M, De Rosa S, Tosi F, De Luca D, Conti G. Effects of positive end expiratory pressure (PEEP) on intracranial and cerebral perfusion pressure in pediatric neurosurgical patients. J Neurosurg Anesthesiol. 2013 Jul;25(3):330-4. doi: 10.1097/ANA.0b013e31828bac4d. | |
| 30169680 |
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The initial group (Study Group) received a PEEP level of 4 cmH2O. Tthe second group (Control Group) received no PEEP.
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| Anesthetic Agents | Drug | Anesthetic agents, including propofol, fentanyl, rocuronium, and sevoflurane, were used as part of standard anesthetic management during the procedure. |
|
| mechanical ventilation (MV) | Device | Mechanical ventilation was provided using a standard anesthesia ventilator in volume-controlled mode during surgery. |
|
| diastolic blood pressure | Four times in during the operation. T0: before induction of anesthesia; T1: immediately after the dura was opened; T2: just before the dura was closed; T3: before extubation |
| Peripheral oxygen saturation | Four times in during the operation. T0: before induction of anesthesia; T1: immediately after the dura was opened; T2: just before the dura was closed; T3: before extubation |
| Background |
| Padayachy L, Brekken R, Fieggen G, Selbekk T. Noninvasive Transorbital Assessment of the Optic Nerve Sheath in Children: Relationship Between Optic Nerve Sheath Diameter, Deformability Index, and Intracranial Pressure. Oper Neurosurg. 2019 Jun 1;16(6):726-733. doi: 10.1093/ons/opy231. |
| 30090129 | Background | Khandelwal A, Kapoor I, Mahajan C, Prabhakar H. Effect of Positive End-Expiratory Pressure on Optic Nerve Sheath Diameter in Pediatric Patients with Traumatic Brain Injury. J Pediatr Neurosci. 2018 Apr-Jun;13(2):165-169. doi: 10.4103/jpn.JPN_112_17. |
| ID | Term |
|---|---|
| D000768 | Anesthesia, General |
| D000777 | Anesthetics |
| D012121 | Respiration, Artificial |
| ID | Term |
|---|---|
| D000758 | Anesthesia |
| D000760 | Anesthesia and Analgesia |
| D002492 | Central Nervous System Depressants |
| D045505 | Physiological Effects of Drugs |
| D020228 | Pharmacologic Actions |
| D020164 | Chemical Actions and Uses |
| D002491 | Central Nervous System Agents |
| D045506 | Therapeutic Uses |
| D058109 | Airway Management |
| D013812 | Therapeutics |
| D012151 | Resuscitation |
| D004638 | Emergency Treatment |
| D012138 | Respiratory Therapy |
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