Increase in Intracranial Pressure During Carbon Dioxide Pneumoperitoneum with Steep Trendelenburg Positioning Proven by Ultrasonographic Measurement of Optic Nerve Sheath Diameter

Abstract

In patients undergoing RALRP, the increase of 12.5% in ONSD during CO2 pneumoperitoneum with steep Trendelenburg positioning was observed and thus the increase of ICP corresponding to this change of ONSD could be predicted. In 15% of the enrolled patients, ONSD increased by values equivalent to an ICP above 20 mm Hg without a deterioration of rSO2 or any neurologic complications.