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Journal of anesthesia, analgesia and critical care
Feb 17, 2025;5 (1): 8.

Intracranial pressure estimated non-invasively and postoperative outcomes in surgery in the Trendelenburg position with pneumoperitoneum.

Christina von Knorring, Megan Gjordeni, Tina Thomsson, Ann-Charlotte Lindström, Jakob Pansell
Author Information
  1. Christina von Knorring: Karolinska University Hospital, Solna, Sweden.
  2. Megan Gjordeni: Karolinska Institutet, Solna, Sweden.
  3. Tina Thomsson: Karolinska University Hospital, Solna, Sweden.
  4. Ann-Charlotte Lindström: Karolinska University Hospital, Solna, Sweden.
  5. Jakob Pansell: Karolinska University Hospital, Solna, Sweden. jakob.pansell@regionstockholm.se.
PMID: 39962515 DOI: 10.1186/s44158-025-00229-y

Abstract

BACKGROUND: Surgery in the Trendelenburg position (TP) with pneumoperitoneum (PP) is beneficial in several aspects but is associated with postoperative complications, such as postoperative nausea and vomiting (PONV). The mechanism behind this is unknown, but an increase in intracranial pressure (ICP) has been suggested. There are several studies of non-invasively estimated ICP during surgery in TP with PP. The association between perioperative estimated ICP and postoperative complications has not yet been reviewed.
METHODS: We performed a scoping review of peer-reviewed clinical studies reporting on both perioperative estimation of ICP and postoperative complications in patients undergoing surgery in TP with PP. The literature search was performed in February 2025 on PubMed, CINAHL, and Web of Science.
RESULTS AND CONCLUSIONS: Ten of 12 included studies suggested associations between perioperative elevation of estimated ICP and postoperative complications, most notably PONV. This may have clinical implications since elevated ICP can be treated. Future research should focus on the association between perioperative ICP estimation and postoperative complications and the effects of ICP-lowering strategies on postoperative outcomes.

Keywords

Intracranial pressure Optic nerve sheath diameter Pneumoperitoneum Trendelenburg

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Journal Article Review

Word Cloud

Created with Highcharts 10.0.0postoperativeICPcomplicationsestimatedperioperativeTrendelenburgTPPPpressurestudiessurgerypositionpneumoperitoneumseveralPONVsuggestednon-invasivelyassociationperformedclinicalestimationoutcomesIntracranialBACKGROUND:SurgerybeneficialaspectsassociatednauseavomitingmechanismbehindunknownincreaseintracranialyetreviewedMETHODS:scopingreviewpeer-reviewedreportingpatientsundergoingliteraturesearchFebruary2025PubMedCINAHLWebScienceRESULTSANDCONCLUSIONS:Ten12includedassociationselevationnotablymayimplicationssinceelevatedcantreatedFutureresearchfocuseffectsICP-loweringstrategiesOpticnervesheathdiameterPneumoperitoneum

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