Evaluation of the effects of LMA supreme, baska mask LMA and endotracheal intubation on intracranial pressure in laparoscopic operations by measuring the diameter of the sonographic optic nerve sheath

Abstract

Aim: The laryngeal mask (LMA) has been used for years to provide a safe and effective airway. Nowadays, it is also preferred in gynecological laparoscopic operations. In our study, we aimed to evaluate the effects of Baska Mask LMA (LMA-B), LMA Supreme (LMA-S) and ETT (endotracheal tube) applications on intracranial pressure in laparoscopic gynecological operations by measuring optic nerve sheath diameter (ONSD).

 Methods:  Patients between the ages of 18-65 in ASA I-II-III physical status who were going to undergo laparoscopic gynecological operation were included in the study. The patients were divided into three groups by randomisation prospective as ETT, LMA-B and LMA-S. ONCD measurements were measured before general anesthesia (T0), 1 minute after induction (T1), 1 minute after intubation (T2), 3 minutes after intubation (T3), 10 minutes after the pneumoperitoneum and trendelenburg position (T4), and 30 minutes after the pneumoperitoneum and trendelenburg position (T5) and before extubation (T6).

Results: 60 patients were included in the study. No statistical difference was found between the groups in terms of demographic characteristics and clinical data (all p>0.05). The change in ONSD within three different groups showed an increase in the measurements at the 10th and 30th minutes after the pneumoperitoneum and trendelenburg position; ETT (4.84±0.23 mm), LMA-S (4.83±0.28mm), and this increase was found to be the lowest in LMA-B (4.64±0.26 mm) application (p=0.61).

Conclusion: we think that Baska Mask LMA can be preferred more than ETT and other LMA applications according to the indication and IBP follow-up can be done reliably with ONSD measurements.