Observational studyBMC anesthesiology2026
Multimodal perioperative monitoring of intracranial pressure surrogates and cerebral oxygenation during laparoscopic surgery: implications for early cognitive outcomes.
Observational study in BMC anesthesiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07264764 (Evaluation of Optic Nerve Sheath Diameter, Cerebral Oxygen Saturation and Cognitive Functions in Patients Undergoing Laparoscopic Abdominal Surgeries; Prospective Observational Study), which is not on this map. Not yet cited in PubMed.
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Evaluation of Optic Nerve Sheath Diameter, Cerebral Oxygen Saturation and Cognitive Functions in Patients Undergoing Laparoscopic Abdominal Surgeries; Prospective Observational Study
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3 authors.
Funding
Abstract
purposeThis study aimed to evaluate perioperative changes in optic nerve sheath diameter (ONSD) and regional cerebral oxygen saturation (rSO₂) using noninvasive monitoring techniques during laparoscopic abdominal surgery, and to assess their association with postoperative cognitive dysfunction (POCD).
methodsThis prospective observational study included 50 ASA I-III patients aged 20-60 years undergoing laparoscopic abdominal surgery under general anesthesia. Bilateral ONSD and rSO₂ were measured at five time points: before induction (T0), 5 min after induction (T1), 5 min after CO₂ pneumoperitoneum (T2), 30 min after pneumoperitoneum (T3), and 5 min after desufflation (T4). IAP was assessed using intravesical measurements and insufflator readings. Cognitive function was evaluated with the Mini-Mental State Examination (MMSE) preoperatively and 24 h postoperatively. Hemodynamic and airway parameters were recorded concurrently.
resultsONSD increased significantly following pneumoperitoneum, peaking at 30 min, and returned toward baseline after desufflation. In contrast, rSO₂ demonstrated a non-synchronous pattern, increasing after induction, decreasing transiently after pneumoperitoneum, and subsequently recovering toward post-induction levels, suggesting preserved cerebral oxygenation despite intraoperative physiological changes. No significant correlation was observed between ONSD and rSO₂. Intravesical intra-abdominal pressure (IAP) measurements were consistently higher than insufflator-derived values. No significant differences were found between preoperative and postoperative MMSE scores.
conclusionsCO₂ pneumoperitoneum induces transient increases in intracranial pressure (ICP) surrogates and reversible changes in cerebral oxygenation without affecting early postoperative cognitive function. These findings support the use of multimodal monitoring rather than reliance on single parameters.
trial registrationThe study was retrospectively registered at ClinicalTrials.gov. CLINICALTRIALS: gov identifier: NCT07264764. Registered on 24 November 2025.
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