• Serbulent Gokhan Beyaz, Burak Kaya, Ali Metin Ulgen, Fatih Sahin, Havva Kocayigit, and Zeynep Tuncer Issi.
• Department of Anesthesiology and Pain Medicine, Sakarya University Faculty of Medicine, Turkey.
• Pain Physician. 2021 Aug 1; 24 (5): E595-E600.

BackgroundIn order to clarify the camera image and open the adhesions mechanically during epiduroscopy, saline is injected continuously in the epidural area. As a result, an increase in intracranial pressure is to be expected in theory. Increased intracranial pressure can be evaluated by measuring by optic nerve sheath diameter.ObjectivesThis study was designed to evaluate the relationship between optic nerve sheath diameter measurements and intracranial pressure, after injecting fluid to the epidural area during epiduroscopy procedures performed in our clinic.Study DesignRetrospective study.SettingSakarya University Training and Research Hospital.MethodsDuring the epiduroscopy procedure, pre and postoperative bilateral optic nerve sheath diameters were measured with an ultrasonography probe. With the patients' eyelids closed, the probe was placed on the orbita in the sagittal plane, measuring 3 mm posterior of the papilla.ResultsWhile there was a statistically significant difference between pre- and post-operative optic nerve sheath diameter measurements, there was no significant correlation with processing time, amount of fluid delivered, or fluid delivery rates.LimitationsOne of the limitations of this study is the retrospective collection of data. A second limitation is that repetitive measurements were not performed, instead of a single postoperative measurement.ConclusionWe think more prospective randomized controlled studies are required to examine the increase in the diameter of the optic nerve sheath, which is an indirect indicator of increased intracranial pressure after epiduroscopy applications, in order to determine whether the pressure increase is associated with the rate of fluid delivery, the total fluid amount, or the processing time.

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