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Table 4.2. Reports and studies on TCD monitoring for noninvasive ICP assessment during pneumoperitonaeum.
Case reports (adults) Case series (adults) Case series (pediatric)
Number of patients Staikou C et al., 2014 Ravaoherisoa et al., 2004 Kirkinen et al., 1995 Colomina M et al., 2003 Kalmar et al., 2012 Abe et al., 1998 De Cosmo 1999 Fujii et al., 1994 Karsli et al., 2011 Huetteman et al., 2002
Sex distribution 1 1 15 17 (11 measured) 21 (14
measured) 14 18 10 36 (2 groups) 12
Weight
kg± sd,(range) Male Female All women 5,8% males All men All women 55,5% males 60% males NA Height cm± sd,( range) NA NA 64,4±10,3 63 (52-72) NA 55,2±7,6 NA 58,1±8,4 24,4±12,1 & 34,5±15,8, Age NA NA 165,5±7,1 164 (152-173) NA 161±6,4 NA 159,2±10,3 NA mean 40 36 NA NA 15, ±5 sd NA NA 40,8 38 63 37,6 52,5 50,1 6 & 9 range NA NA 5,7 NA 8 9,9 14,9 4,1 & 4,7 3 median NA NA NA 28-44 NA 22-45 33-73 25-77 NA 18 months-16 years ASA NA NA NA NA NA NA NA NA NA Type of procedure(s) NA NA 1 to 2 1 to 2 NA 1 to 2 1 to 2 1 to 2 1 to 2 1
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Anesthetic drugs adrenal gland adenoma , pt with VPS ovarian cyst resection, pt with VP S gynecologica l procedures anterior L5-S1
interbody fusion RALRP
gynecologi cal procedures VLC VLC urologic or general surgery Laparoscopi c herniorrhaph y Duration of surgery (mins) Propofol, remifent anil propofol, sulfentanil Isofluoran, fentanyl desfluorane fentanyl sevofluoranesul fentanil Sevofluora ne, N20 fenanyl Isofluorane, N20, fentanyl Isofluorane, remifentanil Isofluorane, remifentanil sevofluorane , N20 Duration of pneumo (mins±sd) NA 50 129±54 360 NA NA 68±14 NA NA Trendelemburg (yes/no) NA 35 NA 240 149 ±83 NA NA NA NA
IAP (mmHg) no no yes yes yes yes no yes no no
MAP
(mmHg) in relation to PP
10 to 14 <12 NA 10 to 12 10 10 NA 10 12 12
PCO2
(mmHg) NA incr. after PP N.S. change N.S. change
decr. during
trend N.S.
decr. sign. before PP, then
normalized
incr. sign. after
PP incr. after PP
incr. after PP
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ETCO2
(mmHg) NA NA NA incr. sign. incr. sign. incr. sign. N.S. incr. incr. sign. NA incr. sign.
Total Number of Meas. during the procedure 32-35 NA 4,5-5% <34-38 mmHg NA 30-35 <44 33-46** 33-45** 34-38 TCD FVm (cm/s) 5 1 meas. every 3 mins interval 6 5 1 meas. every 10 mins interval 4 10 meas.s 6
every min for 10 mins, then every 2 mins &
in deflation
2, pre & post-op
PI incr. N.S. change N.S. change N.S. change N.S. change incr. sign. incr. sign. incr. sign. incr. sign. incr. sign. laparo influences
TCD* Stat sign
Neur complications
N.S.
change N.S. change N.S. change N.S. change N.S. change
N.S. changes NA NA NA decr. No NA No, except during high IAPs NA N.S. change N.S. change p>0.05 No compromise CPP or CBF resistance Yes p<0.05 Yes p<0.05 Yes p<0.01 Yes p<0.05 Yes
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*It refers with a statistically significant value as described by the authors** detected from a graph.
Abbreviations: ASA, American Society of Anesthesiologist;, BMI, Body Mass Index; sd, standard deviation; IAP, Intrabdominal pressure; incr., increases; MAP, Mean Arterial Pressure; meas., measurement; mins, minutes; NA, Not Available; N.S. no significant, ONSD, Optic nerve sheet diameter; PaCO2=Partial Pressure of carbon dioxide; PP, pneumoperitoneum; RALRP, Robot assisted laparoscopic radical prostatectomy, signif, significant(ly); Trend, trendelemburg; VPS, Ventriculoperitoneal Shunt; VLC, Videolaparocholecistectomy, Transperitoneal vs Retroperitoneal Laparoscopy.
No No p>0.05 PI/MAP r=0.370 p<0.03 No 8 headaches p>0.05 No PCO2/FV r=0.669 NA PCO2 r=0.433 MAP r=0.41 ETCO2 r=0.38 No PCO2 r=0.82 NA No No
