The Effects of Spinal Anaesthesia and Tourniquet Use on Optic Nerve Sheath Diameter in Total Knee Replacement Cases

Zübeyir Cebeci; Ebru Canakci

Makale detayları

The Effects of Spinal Anaesthesia and Tourniquet Use on Optic Nerve Sheath Diameter in Total Knee Replacement Cases

Yazarlar:

Zübeyir Cebeci | Ebru Canakci

Yayıncı:

Selcuk University

Ana Başlıklar:

Klinik Tıp Bilimleri

Dergi:

Genel Tıp Dergisi Vol.33 Issue 1, pp.67-71

Belge Tipi:

Makale

Yayın Tarihi:

2/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001284532

pISSN:

2602-3741

Anahtar kelimeler:

Özet:

 Abstract: Backgraound: Optic nerve sheath diameter measurement is a non-invasive method that provides rapid results in intracranial pressure assessment. Our aim in this study is to investigate how spinal anesthesia and tourniquet use affect optic nerve sheath diameter values in total knee arthroplasty operations. Methods:30 cases were included in the study. After spinal anesthesia, the tourniquet cuff was inflated. Right and left optic nerve sheath diameter measurements were performed 5 times with ocular ultrasound before spinal anesthesia, after spinal anesthesia, at 10th minutes after tourniquet inflation, 30th minutes after tourniquet inflation, and after tourniquet was deflated. The measurements were recorded in centimeters. During the first 24 hours postoperatively, the patients were followed up for the headache andor visual impairment. Results: A significant difference was found between optic nerve sheath diameter values before and after spinal anesthesia p0.001, p0.001. When comparing the optical diameter, tourniquet and tourniquet deflation values obtained on the right and left sides over time, we found a linear increase. Conclusion: The use of a tourniquet in spinal anesthesia and orthopedic surgery increases intracranial pressure. Optical measurement of nerve sheath diameter is a non-invasive and successful method that can be used safely for diagnosis and follow-up of elevated intracranial pressure. We believe that anesthesiologists should pay more attention to the measurement of optic nerve sheath diameter in clinical practice.

 Abstract: Backgraound: Optic nerve sheath diameter measurement is a non-invasive method that provides rapid results in intracranial pressure assessment. Our aim in this study is to investigate how spinal anesthesia and tourniquet use affect optic nerve sheath diameter values in total knee arthroplasty operations. Methods:30 cases were included in the study. After spinal anesthesia, the tourniquet cuff was inflated. Right and left optic nerve sheath diameter measurements were performed 5 times with ocular ultrasound before spinal anesthesia, after spinal anesthesia, at 10th minutes after tourniquet inflation, 30th minutes after tourniquet inflation, and after tourniquet was deflated. The measurements were recorded in centimeters. During the first 24 hours postoperatively, the patients were followed up for the headache andor visual impairment. Results: A significant difference was found between optic nerve sheath diameter values before and after spinal anesthesia p0.001, p0.001. When comparing the optical diameter, tourniquet and tourniquet deflation values obtained on the right and left sides over time, we found a linear increase. Conclusion: The use of a tourniquet in spinal anesthesia and orthopedic surgery increases intracranial pressure. Optical measurement of nerve sheath diameter is a non-invasive and successful method that can be used safely for diagnosis and follow-up of elevated intracranial pressure. We believe that anesthesiologists should pay more attention to the measurement of optic nerve sheath diameter in clinical practice.

 Abstract: Backgraound: Optic nerve sheath diameter measurement is a non-invasive method that provides rapid results in intracranial pressure assessment. Our aim in this study is to investigate how spinal anesthesia and tourniquet use affect optic nerve sheath diameter values in total knee arthroplasty operations. Methods:30 cases were included in the study. After spinal anesthesia, the tourniquet cuff was inflated. Right and left optic nerve sheath diameter measurements were performed 5 times with ocular ultrasound before spinal anesthesia, after spinal anesthesia, at 10th minutes after tourniquet inflation, 30th minutes after tourniquet inflation, and after tourniquet was deflated. The measurements were recorded in centimeters. During the first 24 hours postoperatively, the patients were followed up for the headache andor visual impairment. Results: A significant difference was found between optic nerve sheath diameter values before and after spinal anesthesia p0.001, p0.001. When comparing the optical diameter, tourniquet and tourniquet deflation values obtained on the right and left sides over time, we found a linear increase. Conclusion: The use of a tourniquet in spinal anesthesia and orthopedic surgery increases intracranial pressure. Optical measurement of nerve sheath diameter is a non-invasive and successful method that can be used safely for diagnosis and follow-up of elevated intracranial pressure. We believe that anesthesiologists should pay more attention to the measurement of optic nerve sheath diameter in clinical practice.

 Giriş ve Amaç: Optik sinir kılıf çapı ölçümü, intrakranial basınç değerlendirmesini sağlayan ve hızlı sonuç veren non-invazif bir yöntemdir. Bu çalışmadaki amacımız, total diz artroplastisi ameliyatlarında , spinal anestezinin ve turnike kullanımının optik sinir kılıf çapı değerlerini nasıl etkilediğini araştırmaktır. Material ve Method: Çalışmaya 30 olgu dahil edildi, olguların demografik verileri kaydedildi. Spinal anestezi yapıldıktan sonra turnike manşonu şişirildi. Sağ ve sol optik sinir kılıf çapları; spinal anestezi öncesi, spinal anestezi sonrası , turnike şişirilmesi sonrası 10. dakikada, turnike şişirilmesi sonrası 30. dakika ve turnike indirildikten sonra olmak üzere 5 kez okuler usg ile optik sinir kılıf çapı ölçümü yapıldı. Ölçümler santimetre olarak kaydedildi.Postoperatif ilk 24 saatlik dönemde olguların başağrısı ve veya görme bozukluğu olup olmadığı takip edildi. Bulgular: Vücut kitle indeksi, ameliyat süresi, turnike süresi, turnike basıncı ile spinal öncesi optik sinir kılıf çap değerleri arasında istatistiksel olarak anlamlı bir ilişki bulunmamıştır p0.050. Spinal anestezi öncesi ve sonrası optik sinir kılıf çapı değerleri arasında anlamlı fark tespit edilmiştir p0.001, p0.001. Zamana göre sağ-sol tarafta elde edilen optik çap, turnike ve turnike indirme değerlerinin karşılaştırılması yapıldığında lineer bir artış olduğunu tespit ettik. Postoperatif ilk 24 saatlik dönemde , başağrısı ve veya görme bozukluğu olan olguya rastlanmamıştır. Sonuç: Spinal anestezi ve ortopedik cerrahide kullanılan turnike kullanımı intrakranial basıncı artırmaktadır. Artmış intrakranial basınçta optik sinir kılıf çapını artırmaktadır. İntrakranial basınç artışının tanı ve takibinde, optik sınır kılıf çapı ölçümü güvenle kullanılabilecek non-invaziv ve başarılı bir yöntemdir. Anesteziyologların optik sinir kılıf çapı ölçümüne, klinik pratikte daha fazla yer vermesi gerektiği inancındayız.

Makale detayları

The Effects of Spinal Anaesthesia and Tourniquet Use on Optic Nerve Sheath Diameter in Total Knee Replacement Cases

Yazarlar:

Zübeyir Cebeci | Ebru Canakci

Yayıncı:

Selcuk University

Ana Başlıklar:

Klinik Tıp Bilimleri

Dergi:

Genel Tıp Dergisi Vol.33 Issue 1, pp.67-71

Belge Tipi:

Makale

Yayın Tarihi:

2/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001284532

pISSN:

2602-3741

Optical nerve diamater

tourniquet

total knee replacement

Optik sinir çapı

Turnike

Total diz protezi

intra kraniyal basınç

intracranial pressure

Sayı

Makale detayları

Yazarlar: Zübeyir Cebeci | Ebru Canakci

Yayıncı: Selcuk University

Ana Başlıklar: Klinik Tıp Bilimleri

Dergi: Genel Tıp Dergisi Vol.33 Issue 1, pp.67-71

Belge Tipi: Makale

Yayın Tarihi: 2/2023

Belge Dili: İngilizce

Document ID (Org No.): 2001284532

pISSN: 2602-3741

Sayı

Yazarlar:

Zübeyir Cebeci | Ebru Canakci

Yayıncı:

Selcuk University

Ana Başlıklar:

Klinik Tıp Bilimleri

Dergi:

Genel Tıp Dergisi Vol.33 Issue 1, pp.67-71

Belge Tipi:

Makale

Yayın Tarihi:

2/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001284532

pISSN:

2602-3741