Overview
This prospective interventional study will evaluate the effects of applying positive end-expiratory pressure (PEEP) at 10 cmH₂O on optic nerve sheath diameter (ONSD) in patients undergoing elective laparoscopic cholecystectomy under general anesthesia. A total of approximately 80 adult patients (ASA physical status I-III) will be included following informed consent.
ONSD will be measured using a high-frequency linear ultrasound probe at three predefined intraoperative time points: (T0) 10 minutes after initiation of mechanical ventilation, (T1) 10 minutes after pneumoperitoneum creation, and (T2) 30 minutes after pneumoperitoneum creation. Dynamic lung compliance, peak airway pressure (Ppeak), end-tidal CO₂ (EtCO₂), heart rate, mean arterial pressure, and SpO₂ will also be recorded.
The aim is to assess whether the application of PEEP influences intracranial pressure indicators, particularly ONSD, during laparoscopic procedures. The study may provide valuable insights into the neurophysiological effects of intra-abdominal pressure and mechanical ventilation strategies in surgical patients.
Eligibility
Inclusion Criteria:
- Adult patients (age ≥ 18 years)
American Society of Anesthesiologists (ASA) physical status I-III
Scheduled for elective laparoscopic cholecystectomy under general anesthesia
Signed informed consent
Exclusion Criteria:
- resence of acute or chronic eye disease
Uncontrolled hypertension
Asthma or known chronic pulmonary disease
Any neurological disorders
Body mass index (BMI) > 35 kg/m²
Use of medications known to affect intracranial pressure
Refusal to participate after signing informed consent