PURPOSE Optic nerve sheath diameter has been used for measure of intracranial pressure. The aim of this study was to evaluate the effect of prone positioning with neck extension on intracranial pressure in infants undergoing craniosynostosis surgery and to determine precautions using optic nerve sheath diameter measurement. METHODS We enrolled 30 infants who were scheduled for correction of craniosynostosis in which planning included the prone position with neck extension. Optic nerve sheath diameter (anterior/lateral transbulbar approach) was measured 5 times in each eyeball at the following time points: 15 min after intubation in supine position as the baseline value (supine 1); 10 min after final surgical position before skin incision (prone); and 10 min after returning to supine position at the conclusion of surgery (supine 2). Hemodynamic parameters, airway peak pressure, oxygen saturation, and ETCO2 were monitored. Data were analyzed using repeated-measures multivariate analysis of variance to evaluate the effect of different positions under anesthesia on changes in using optic nerve sheath diameter and P < 0.05 was considered to be statistically significant. RESULTS There was no difference in optic nerve sheath diameter after prone position with neck extension in all the measure. After surgery, optic nerve sheath diameter was decreased compared with the preoperative baseline values (Rt anterior/lateral 5.6/5.5: 5.4/5.2; Lt anterior/lateral 5.6/5.5: 5.4/5.3, P < 0.05, respectively). CONCLUSIONS In conclusion, prone positioning with head extension did not further increase intracranial pressure, although the surgical procedure could reduce intracranial pressure in the immediate postoperative period in infants undergoing craniosynostosis surgery.

中文翻译：

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根据儿童超声测得的视神经鞘管直径，俯卧位和颈部延伸对颅内压的影响。

目的视神经鞘管直径已用于测量颅内压。这项研究的目的是评估俯卧位和颈部延伸对颅内突吻合术婴儿的颅内压的影响，并通过视神经鞘管直径测量确定预防措施。方法我们招募了30名计划矫正颅骨前突的婴儿，其中计划包括俯卧位和颈部伸展。在以下时间点在每个眼球中测量5次视神经鞘管直径（前/外侧经球入路）：仰卧位插管后15分钟作为基线值（仰卧位1）；最终手术位置后10分钟，皮肤切口前（俯卧）；手术结束后回到仰卧位10分钟（仰卧位2）。监测血流动力学参数，气道峰值压力，氧饱和度和ETCO2。使用重复测量多元方差分析对数据进行分析，以评估麻醉下不同位置对使用视神经鞘管直径变化的影响，P <0.05被认为具有统计学意义。结果在所有措施中，俯卧位后颈部延伸的视神经鞘管直径均无差异。手术后，视神经鞘管直径较术前基线值减少（Rt前/外侧5.6 / 5.5：5.4 / 5.2； Lt前/外侧5.6 / 5.5：5.4 / 5.3，P <0.05）。结论总而言之，俯卧位与头部伸展并没有进一步增加颅内压，