Evaluation of intracranial pressure using optic nerve sheath diameter in patients undergoing thulium laser prostatectomy with spinal or general anesthesia

Aims: This study aims to evaluate optic nerve sheath diameter (ONSD) measurements as a non-invasive indicator of intracranial pressure in patients undergoing Thulium Laser Prostatectomy (ThuLEP) under spinal or general anesthesia. Methods: 44 patients aged 18-90 years were included in this prospective observational clinical study. Patients were randomly divided into general anesthesia and spinal anesthesia groups. ONSD measurements were made before, during and after surgery. Mann-Whitney U test, Wilcoxon signed rank test and Spearman chi-square test were used in statistical analysis. Results: There was no statistically significant difference in preoperative, intraoperative and postoperative ONSD values between both groups. In patients who underwent general and spinal anesthesia, an increase in ONSD values was observed after anesthesia compared to the preoperative period. Conclusion: ONSD measurement may be a useful, non-invasive technique for assessing intracranial pressure. This study showed that both anesthesia methods had similar effects on intracranial pressure. However, studies with a larger number of patients are needed to evaluate the effect of anesthesia management and surgical position on intracranial pressure.