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Comparison of the effect of sevoflurane and propofol on the optic nerve sheath diameter in patients undergoing middle ear surgery

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A Letter to the Editor to this article was published on 27 October 2023

Abstract

Purpose

During middle ear surgery, the patient’s head is turned away from the surgical site, which may increase the intracranial pressure. Anesthetics also affect the intracranial pressure. The optic nerve sheath diameter (ONSD) measured using ultrasonography is a reliable marker for estimating the intracranial pressure. This aim of this study was to investigate the effect of sevoflurane and propofol on the ONSD in patients undergoing middle ear surgery.

Methods

Fifty-eight adult patients were randomized into sevoflurane group (n = 29) or propofol group (n = 29). The ONSD was measured using ultrasound after anesthesia induction before head rotation (T0), and at the end of surgery (T1). The occurrence and severity of postoperative nausea and vomiting (PONV) were assessed 1 h after the surgery.

Results

The ONSD was significantly increased from T0 to T1 in the sevoflurane group [4.3 (0.5) mm vs. 4.9 (0.6) mm, respectively; P < 0.001] and the propofol group [4.2 (0.3) mm vs. 4.8 (0.5) mm, respectively; P < 0.001]. No significant difference was observed in the ONSD at T0 (P = 0.267) and T1 (P = 0.384) between the two groups. The change in the ONSD from T0 to T1 was not significantly different between the sevoflurane and propofol groups [0.6 (0.4) mm vs. 0.6 (0.3) mm, respectively; P = 0.972]. The occurrence and severity of PONV was not significantly different between the sevoflurane and propofol groups (18% vs. 0%, respectively; P = 0.053).

Conclusion

The ONSD was significantly increased during middle ear surgery. No significant difference was observed in the amount of ONSD increase between the sevoflurane and propofol groups.

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Funding

This study was not funded.

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Authors and Affiliations

  1. Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, College of Medicine, Seoul National University, Boramae-ro 5, Dongjak-gu, Seoul, 07061, Republic of Korea

    Jee-Eun Chang, Hyerim Kim, Dongwook Won, Jung-Man Lee, Tae Kyong Kim & Jin-Young Hwang

  2. Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea

    Yeonsoo Kang

  3. Department of Anesthesiology and Pain Medicine, Kangwon Naional University Hospital, College of Medicine, Kangwon National University, Kangwondo, Republic of Korea

    Jin Huh

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  1. Jee-Eun Chang
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Chang, JE., Kim, H., Won, D. et al. Comparison of the effect of sevoflurane and propofol on the optic nerve sheath diameter in patients undergoing middle ear surgery. J Anesth 37, 880–887 (2023). https://doi.org/10.1007/s00540-023-03248-7

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  • DOI: https://doi.org/10.1007/s00540-023-03248-7

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