VIMA vs TIVA and ONSD in Laparoscopic Cholecystectomy

This study compared two commonly used general anesthesia techniques in adults undergoing elective laparoscopic gallbladder surgery. One group received total intravenous anesthesia (TIVA) with propofol, while the other group received volatile induction and maintenance anesthesia (VIMA) with sevoflurane. The main purpose of the study was to compare changes in optic nerve sheath diameter, measured noninvasively by ultrasound, because this measurement can reflect changes in pressure inside the skull. Measurements were taken at several time points before, during, and after surgery. The study also compared blood pressure, heart rate, oxygen levels, depth of anesthesia, breathing-related measurements, postoperative pain, nausea, vomiting, headache, recovery time, and anesthetic drug cost between the two groups. Adult patients aged 18 to 80 years with ASA physical status I-II who were scheduled for elective laparoscopic cholecystectomy were included. The study was conducted at Istanbul Bağcılar Training and Research Hospital.

Inclusion Criteria: * Age 18-80 years * American Society of Anesthesiologists (ASA) physical status I-II * Scheduled for elective laparoscopic cholecystectomy * Provided written informed consent to participate Exclusion Criteria: * Refusal to participate * Uncontrolled hypertension * Uncontrolled diabetes mellitus * History of malignancy * Severe cardiovascular disease, including congestive heart failure or myocardial infarction * Severe cerebrovascular disease, including previous stroke * Hepatic dysfunction * Renal dysfunction * Pregnancy or lactation * Intracranial space-occupying lesion or any condition predisposing to increased intracranial pressure * Known optic nerve pathology