Sonographie des Nervus opticus und der Zentralarterie

Nedelmann, Max

doi:10.1016/j.neulab.2014.10.001

Cited by 1 publication

(2 citation statements)

References 18 publications

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“…This might contribute to an improvement in patient monitoring and safety. The easy-to-perform and non-invasive control of the ONSD [31] might be established as a standard monitoring tool within the department of anesthesiology and thus further improve the training of young colleagues.…”

Section: Risk-benefit Assessmentmentioning

confidence: 99%

“…Focused sonography will be performed according to standardized operating procedures [31]: The optic nerve will be marked at a depth of 3 mm behind the retinal plane. At this depth, the transverse diameter will then be determined by a pair of measuring points, which are placed directly lateral to the reflex-rich cerebrospinal fluid space.…”

Section: Onsd/extracranial Blood Vesselsmentioning

confidence: 99%

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Assessing Stress Induced by Fluid Shifts and Reduced Cerebral Clearance during Robotic-Assisted Laparoscopic Radical Prostatectomy under Trendelenburg Positioning (UroTreND Study)

Peschke,

Feuerecker,

Siegl

et al. 2024

MPs

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In addition to general anesthesia and mechanical ventilation, robotic-assisted laparoscopic radical prostatectomy (RALP) necessitates maintaining a capnoperitoneum and placing the patient in a pronounced downward tilt (Trendelenburg position). While the effects of the resulting fluid shift on the cardiovascular system seem to be modest and well tolerated, the effects on the brain and the blood–brain barrier have not been thoroughly investigated. Previous studies indicated that select patients showed an increase in the optic nerve sheath diameter (ONSD), detected by ultrasound during RALP, which suggests an elevation in intracranial pressure. We hypothesize that the intraoperative fluid shift results in endothelial dysfunction and reduced cerebral clearance, potentially leading to transient neuronal damage. This prospective, monocentric, non-randomized, controlled clinical trial will compare RALP to conventional open radical prostatectomy (control group) in a total of 50 subjects. The primary endpoint will be the perioperative concentration of neurofilament light chain (NfL) in blood using single-molecule array (SiMoA) as a measure for neuronal damage. As secondary endpoints, various other markers for endothelial function, inflammation, and neuronal damage as well as the ONSD will be assessed. Perioperative stress will be evaluated by questionnaires and stress hormone levels in saliva samples. Furthermore, the subjects will participate in functional tests to evaluate neurocognitive function. Each subject will be followed up until discharge. Conclusion: This trial aims to expand current knowledge as well as to develop strategies for improved monitoring and higher safety of patients undergoing RALP. The trial was registered with the German Clinical Trials Register DRKS00031041 on 11 January 2023.

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Section: Risk-benefit Assessmentmentioning

confidence: 99%

Section: Onsd/extracranial Blood Vesselsmentioning

confidence: 99%