Cambios en el diámetro de la vaina del nervio óptico en niños llevados a cirugía laparoscópica en posición supina versus Trendelenburg en el Hospital Infantil de Manizales

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2025
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Universidad de Caldas
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Repositorio Institucional U. Caldas
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spa
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oai:repositorio.ucaldas.edu.co:ucaldas/21939
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https://repositorio.ucaldas.edu.co/handle/ucaldas/21939
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610 - Medicina y salud
3. Ciencias Médicas y de la Salud
Laparoscopia pediátrica
Ultrasonido
Vaina del nervio óptico
Presión intracraneal
Medicina clínica
Ciencias médicas
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oai_identifier_str oai:repositorio.ucaldas.edu.co:ucaldas/21939
network_acronym_str REPOUCALDA
network_name_str Repositorio Institucional U. Caldas
repository_id_str
dc.title.none.fl_str_mv Cambios en el diámetro de la vaina del nervio óptico en niños llevados a cirugía laparoscópica en posición supina versus Trendelenburg en el Hospital Infantil de Manizales
title Cambios en el diámetro de la vaina del nervio óptico en niños llevados a cirugía laparoscópica en posición supina versus Trendelenburg en el Hospital Infantil de Manizales
spellingShingle Cambios en el diámetro de la vaina del nervio óptico en niños llevados a cirugía laparoscópica en posición supina versus Trendelenburg en el Hospital Infantil de Manizales
610 - Medicina y salud
3. Ciencias Médicas y de la Salud
Laparoscopia pediátrica
Ultrasonido
Vaina del nervio óptico
Presión intracraneal
Medicina clínica
Ciencias médicas
title_short Cambios en el diámetro de la vaina del nervio óptico en niños llevados a cirugía laparoscópica en posición supina versus Trendelenburg en el Hospital Infantil de Manizales
title_full Cambios en el diámetro de la vaina del nervio óptico en niños llevados a cirugía laparoscópica en posición supina versus Trendelenburg en el Hospital Infantil de Manizales
title_fullStr Cambios en el diámetro de la vaina del nervio óptico en niños llevados a cirugía laparoscópica en posición supina versus Trendelenburg en el Hospital Infantil de Manizales
title_full_unstemmed Cambios en el diámetro de la vaina del nervio óptico en niños llevados a cirugía laparoscópica en posición supina versus Trendelenburg en el Hospital Infantil de Manizales
title_sort Cambios en el diámetro de la vaina del nervio óptico en niños llevados a cirugía laparoscópica en posición supina versus Trendelenburg en el Hospital Infantil de Manizales
dc.contributor.none.fl_str_mv Isaza Londoño, Carlos Felipe
Arango Gómez, Fernando
dc.subject.none.fl_str_mv 610 - Medicina y salud
3. Ciencias Médicas y de la Salud
Laparoscopia pediátrica
Ultrasonido
Vaina del nervio óptico
Presión intracraneal
Medicina clínica
Ciencias médicas
topic 610 - Medicina y salud
3. Ciencias Médicas y de la Salud
Laparoscopia pediátrica
Ultrasonido
Vaina del nervio óptico
Presión intracraneal
Medicina clínica
Ciencias médicas
description Tablas
publishDate 2025
dc.date.none.fl_str_mv 2025-02-04T20:25:41Z
2025-02-04T20:25:41Z
2025-02-04
dc.type.none.fl_str_mv Trabajo de grado - Especialización
http://purl.org/coar/resource_type/c_93fc
Text
info:eu-repo/semantics/workingPaper
dc.type.coar.fl_str_mv http://purl.org/coar/resource_type/c_8042
dc.identifier.none.fl_str_mv https://repositorio.ucaldas.edu.co/handle/ucaldas/21939
Universidad de Caldas
Repositorio Institucional Universidad de Caldas
repositorio.ucaldas.edu.co
url https://repositorio.ucaldas.edu.co/handle/ucaldas/21939
identifier_str_mv Universidad de Caldas
Repositorio Institucional Universidad de Caldas
repositorio.ucaldas.edu.co
dc.language.none.fl_str_mv spa
language spa
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dc.rights.coar.fl_str_mv http://purl.org/coar/access_right/c_abf2
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Atribución-NoComercial-SinDerivadas 4.0 Internacional (CC BY-NC-ND 4.0)
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dc.format.none.fl_str_mv 32 páginas
application/pdf
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dc.publisher.none.fl_str_mv Facultad de Ciencias para la Salud
Manizales
Especialización en Anestesiología
publisher.none.fl_str_mv Facultad de Ciencias para la Salud
Manizales
Especialización en Anestesiología
institution Universidad de Caldas
repository.name.fl_str_mv
repository.mail.fl_str_mv
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spelling Cambios en el diámetro de la vaina del nervio óptico en niños llevados a cirugía laparoscópica en posición supina versus Trendelenburg en el Hospital Infantil de Manizales610 - Medicina y salud3. Ciencias Médicas y de la SaludLaparoscopia pediátricaUltrasonidoVaina del nervio ópticoPresión intracranealMedicina clínicaCiencias médicasTablasLa cirugía laparoscopia pediátrica dado sus beneficios se ha incrementado en las últimas décadas. Sin embargo, este procedimiento genera cambios fisiológicos que lo hacen un desafío para el anestesiólogo. Entre los cambios esperados por el neumoperitoneo, la hipercapnia y la posición de Trendelenburg, es el posible que se aumente la presión intracraneal (PIC). La medición ecográfica del diámetro de la vaina del nervio óptico (ONSD) es una herramienta simple, barata, indolora, libre de radiación y no invasiva con un nivel razonable de precisión diagnóstica para estimar la presencia de hipertensión intracraneal. El objetivo del presente estudio fue evaluar los cambios en el ONSD durante neumoperitoneo en posición de Trendelenburg versus supino; como subrogado de PIC, en cirugía laparoscópica en niños. Metodología: Se incluyeron pacientes entre 4 años y 17 años de edad, promedio de 9.6 años, programados para cirugía laparoscopia. Se realizó medición ultrasonográfica del diámetro de la vaina del nervio óptico (ONSD) en 4 momentos: 3 minutos luego de inducción anestésica e intubación orotraqueal, 3 minutos luego del neumoperitoneo, 3 minutos luego de posición de Trendelenburg y una última medición a los 3 minutos de recuperar la posición supina y liberar el neumoperitoneo. Resultados: Los diámetros de la vaina del nervio óptico fueron los siguientes: 6.0  0.5 mm en el momento 1, luego de induccion e ITO. 6.4  0.5 en momento 2; luego del neumoperitoneo. 6.6  0.5 en momento 3, luego de posición Trendelenburg de 10.2°. 6.0  0.4 en momento 4, luego de retirar neumoperitoneo en posición supina, volviendo a valores iniciales. El aumento de ONSD entre cada momento es estadísticamente significativo, excepto entre el momento 1 y momento 4, mostrando como una vez resuelto el neumoperitoneo y la posición de Trendelenburg, las medidas vuelven a los valores basales. No se observaron complicaciones neurológicas en los pacientes durante el período intraoperatorio o postoperatorio. Conclusión: En cirugía laparoscópica, luego del neumoperitoneo se aumenta el ONSD, luego de la posición de Trendelenburg, aumenta aún más. Sin embargo, este aumento fue reversible luego de 3 minutos de recuperar la posición supina y liberar el neumoperitoneo. Palabras clave: Laparoscopia pediátrica, ultrasonido, vaina del nervio óptico, presión intracraneal.Pediatric laparoscopic surgery, given its benefits, has increased in recent decades. However, this procedure generates physiological changes that make it a challenge for the anesthesiologist. Among the changes expected by pneumoperitoneum, hypercapnia, and Trendelenburg position, it is possible that intracranial pressure (ICP) may be increased. Ultrasound measurement of optic nerve sheath diameter (ONSD) is a simple, inexpensive, painless, radiation-free, and noninvasive tool with a reasonable level of diagnostic accuracy to estimate the presence of intracranial hypertension. The aim of the present study was to evaluate the changes in ONSD during pneumoperitoneum in Trendelenburg versus supine position; as a surrogate for ICP, in laparoscopic surgery in children. Methodology: Patients between 4 and 17 years old, average age 9.6 years, scheduled for laparoscopic surgery were included. Ultrasonographic measurement of optic nerve sheath diameter (ONSD) was performed at 4 time points: 3 minutes after anesthetic induction and orotracheal intubation, 3 minutes after pneumoperitoneum, 3 minutes after Trendelenburg position, and a final measurement 3 minutes after recovering the supine position and releasing the pneumoperitoneum. Results: Optic nerve sheath diameters were as follows: 6.0 ± 0.5 mm at time 1, after induction and OIT; 6.4 ± 0.5 at time 2, after pneumoperitoneum; 6.6 ± 0.5 at time 3, after 10.2° Trendelenburg position; 6.0 ± 0.4 at time 4, after pneumoperitoneum removal in supine position, returning to baseline values. The increase in ONSD between each time is statistically significant, except between time 1 and time 4, showing that once pneumoperitoneum and Trendelenburg position are resolved , measurements return to baseline values. No neurological complications were observed in patients during the intraoperative or postoperative period. Conclusion : In laparoscopic surgery, the ONSD increases after pneumoperitoneum , and after the Trendelenburg position, it increases even more. However, this increase was reversible after 3 minutes of recovering the supine position and releasing the pneumoperitoneum. Keywords: Pediatric laparoscopy, ultrasound, optic nerve sheath, intracranial pressure.Introducción / Planteamiento del problema y justificación / Pregunta de Investigación / Marco teórico / Objetivo / Objetivo general / Objetivos específicos / Metodología/ Tipo de estudio / Hipótesis / Población / Tamaño de la muestra / Protocolo anestésico y medición ecográfica / Plan de análisis / Variables / Aspecto éticos / Cronograma / Presupuesto / Resultados / Discusión / Conclusiones / Anexos / ReferenciasEspecializaciónEspecialista en AnestesiologíaFacultad de Ciencias para la SaludManizalesEspecialización en AnestesiologíaIsaza Londoño, Carlos FelipeArango Gómez, FernandoQUINTERO HERRERA, LORENA2025-02-04T20:25:41Z2025-02-04T20:25:41Z2025-02-04Trabajo de grado - Especializaciónhttp://purl.org/coar/resource_type/c_93fcTextinfo:eu-repo/semantics/workingPaperhttp://purl.org/coar/resource_type/c_804232 páginasapplication/pdfapplication/pdfapplication/pdfapplication/pdfhttps://repositorio.ucaldas.edu.co/handle/ucaldas/21939Universidad de CaldasRepositorio Institucional Universidad de Caldasrepositorio.ucaldas.edu.cospaGupta R, Singh S. 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