The role of optic nerve sheath ultrasonography in increased intracranial pressure: A systematic review and meta analysis.
David Berhanu, Joana Cardoso Ferreira, Luís Abegão Pinto...
https://pubmed.ncbi.nlm.nih.gov/37925899Actively Recruiting
Phase Not Applicable
Age: 18Years - 80Years
All Genders
ID06254534
Effect of Lidocaine, Dexmedetomidine, Esmolol and Magnesium on Optic Nerve Sheath Diameter and Hemodynamic Response After Laryngoscopy: Randomized Double-blind Controlled Trial
Led by Haseki Training and Research Hospital · Updated on 2025-03-20
100
Participants Needed
1
Research Sites
4 weeks
Total Duration
On this page
AI-Summary
What this Trial Is About
This clinical trial studies the effects of four drugs—lidocaine, dexmedetomidine, esmolol, and magnesium—on the optic nerve sheath diameter and hemodynamic responses during laryngoscopy. The trial aims to find the best anesthesia induction protocol for patients who are sensitive to changes in intracranial pressure, using optic nerve ultrasonography as a monitoring tool. Participants are patients scheduled for elective surgery requiring intubation and general anesthesia, aged 18 to 80 years with ASA physical status I to III. Participants are randomly assigned to one of five groups: lidocaine, dexmedetomidine, esmolol, magnesium, or a control group receiving only saline. Each drug is administered intravenously over 10 minutes before anesthesia induction. Standard general anesthesia is then given, followed by endotracheal intubation performed by experienced anesthesiologists. The optic nerve sheath diameter is measured by ultrasound at four time points: before laryngoscopy, immediately after, and then five and ten minutes after intubation. During the study, researchers monitor blood pressure, heart rate, bispectral index, and end-tidal carbon dioxide alongside the optic nerve measurements. The goal is to compare changes in optic nerve sheath diameter and hemodynamic responses between groups to identify which drug offers the most stable condition during intubation. The total participation involves these measurements around the anesthesia period, with safety and stability carefully observed throughout.
CONDITIONS
Brief Title
Lidocaine, Dexmedetomidine, Esmolol and Magnesium Effect on Optic Nerve Sheath Diameter After Laryngoscopy
Who Can Participate
Age: 18Years - 80Years
All Genders
Eligibility Criteria
You may qualify if you...
- Patients aged 18 to 80 years
- Scheduled for endotracheal intubation for general anesthesia
- American Society of Anesthesiologists (ASA) Physical Status classification I to III
- Written informed consent obtained
You will not qualify if you...
- Allergy to dexmedetomidine, esmolol, lidocaine, or magnesium
- Uncontrolled hypertension or advanced heart failure with ejection fraction below 35%
- Cardiac arrhythmias, including Type 2 and 3 blocks or supraventricular arrhythmias
- Renal failure with glomerular filtration rate below 30
- Severe liver failure
- Known acute or previous intracranial pathology or epilepsy diagnosis
- Difficult airway examination
- More than one intubation attempt or laryngoscopy lasting more than 20 seconds
AI-Screening
AI-Powered Screening
Complete this quick 3-step screening to check your eligibility
1
2
3
Your Study Journey
Screening
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 screening and enrollment visit (in-person)
Treatment
Duration - Approximately 30 minutes on the day of surgery
Participants receive one of the study drugs or placebo intravenously for 10 minutes before general anesthesia induction. Standard anesthesia and endotracheal intubation are then performed while optic nerve sheath diameter and hemodynamic responses are measured during and shortly after the procedure.
1 treatment visit (in-person)
Trial Site Locations
Total: 1 location
1
Haseki Trainig and Research Hospital
Istanbul, Turkey (Türkiye)
Actively Recruiting
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Research Team
B
Berna Caliskan, MD
How is the study designed?
Study Type
INTERVENTIONAL
Masking
DOUBLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
PREVENTION
Number of Arms
5
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Published Research Related To This Trial
Effects of adding dexmedetomidine to nebulized lidocaine on control of hemodynamic responses to laryngoscopy and intubation: A randomized clinical trial.
Bhavna Sriramka, Zeeshan Haider Warsi, Janmejaya Sahoo
https://pubmed.ncbi.nlm.nih.gov/37250266Nebulised fentanyl, dexmedetomidine and magnesium sulphate for attenuation of haemodynamic response to laryngoscopy and tracheal intubation: A double-blinded, randomised comparative study.
Niharika Grover, Rashmi Taneja, Yawar Rashid...
https://pubmed.ncbi.nlm.nih.gov/37693019