Ultrasonographic assessment of optic nerve sheath diameter during pediatric laparoscopy.

Abstract This study investigated the extent of the raised intracranial pressure resulting from carbon dioxide (CO 2 ) pneumoperitoneum by ultrasonographically measuring optic nerve sheath diameter (ONSD) in children undergoing laparoscopic surgery. Twenty-five children aged less than 9 y (53.1 ± 23.3 mo, mean ± standard deviation) and scheduled for an elective laparoscopic surgery participated. ONSD was assessed using ocular ultrasonography 10 min after induction of anesthesia (T0), 10 min after induction of CO 2 pneumoperitoneum at 10 mm Hg intra-abdominal pressure (T1) and in an anesthetized state without CO 2 pneumoperitoneum at the conclusion of the surgery (T2). During CO 2 pneumoperitoneum, ONSD increased significantly compared with ONSD after anesthesia induction (T0: 4.3 ± 0.3 mm, T1: 4.6 ± 0.3 mm, p 2 pneumoperitoneum, and thus the corresponding increase in intracranial pressure could be predicted.