{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T22:17:20Z","timestamp":1791497840722,"version":"4.3.4"},"reference-count":38,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,4,12]],"date-time":"2023-04-12T00:00:00Z","timestamp":1681257600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Supraglottic airway devices (SADs) are known to be useful in eliminating the drawbacks of laryngoscopy and tracheal intubation, especially ocular pressure and stress responses. The ultrasonographic measurement of optic nerve sheath diameter (ONSD) reflects increases in intracranial pressure (ICP). In our study, we aimed to compare the effects of SADs on hemodynamic response and ONSD. Materials and Methods: Our prospective study included 90 ASA I\u2013II patients over the age of 18 who did not have a history of difficult intubation or ophthalmic pathology. The patients were randomly divided into three groups based on the laryngeal mask airway (LMA) devices used: ProSeal LMA (pLMA, n = 30), LMA Supreme (sLMA, n = 30), and I-gel (n = 30). The bilateral ONSD measurements and hemodynamic data of the patients who underwent standard anesthesia induction and monitoring were recorded before induction (T0) and 1 min (T1), 5 min (T5), and 10 min (T10) after SAD placement. Results: At all measurement times, the hemodynamic responses and ONSD values of the groups were similar. In all three groups, intergroup hemodynamic changes at T0 and T1 were similar and higher than those at other times of measurement (p &lt; 0.001). The ONSD values of all groups increased at T1, and they tended to return to baseline values afterward (p &lt; 0.001). Conclusions: We concluded that all three SADs could be used safely because they preserved both hemodynamic stability and ONSD changes in their placement processes, and they did not cause elevations in ONSD to an extent that would lead to increased ICP.<\/jats:p>","DOI":"10.3390\/medicina59040753","type":"journal-article","created":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T02:29:15Z","timestamp":1681352955000},"page":"753","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Effects of Supraglottic Airway Devices on Hemodynamic Response and Optic Nerve Sheath Diameter: Proseal LMA, LMA Supreme, and I-gel LMA"],"prefix":"10.3390","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0520-7532","authenticated-orcid":false,"given":"Rah\u015fan Dilek","family":"Okyay","sequence":"first","affiliation":[{"name":"Anesthesiology and Reanimation Department, Faculty of Medicine, Zonguldak B\u00fclent Ecevit University, Zonguldak 67600, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3586-7494","authenticated-orcid":false,"given":"Gamze","family":"K\u00fc\u00e7\u00fckosman","sequence":"additional","affiliation":[{"name":"Anesthesiology and Reanimation Department, Faculty of Medicine, Zonguldak B\u00fclent Ecevit University, Zonguldak 67600, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1324-6144","authenticated-orcid":false,"given":"Beng\u00fc G\u00fclhan","family":"K\u00f6ksal","sequence":"additional","affiliation":[{"name":"Anesthesiology and Reanimation Department, Faculty of Medicine, Zonguldak B\u00fclent Ecevit University, Zonguldak 67600, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d6zcan","family":"Pi\u015fkin","sequence":"additional","affiliation":[{"name":"Anesthesiology and Reanimation Department, Faculty of Medicine, Zonguldak B\u00fclent Ecevit University, Zonguldak 67600, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilal","family":"Ayo\u011flu","sequence":"additional","affiliation":[{"name":"Anesthesiology and Reanimation Department, Faculty of Medicine, Zonguldak B\u00fclent Ecevit University, Zonguldak 67600, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1093\/bja\/59.3.295","article-title":"Cardiovascular and catecholamine responses to laryngoscopy with and without tracheal intubation","volume":"59","author":"Shribman","year":"1987","journal-title":"Br. J. Anaesth."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/0952-8180(95)00147-6","article-title":"Controlling the hemodynamic response to laryngoscopy and endotracheal intubation","volume":"8","author":"Kovac","year":"1996","journal-title":"J. Clin. Anesth."},{"key":"ref_3","first-page":"7858434","article-title":"Effect of Laryngeal Mask Airway Insertion on Intraocular Pressure Response: Systematic Review and Meta-Analysis","volume":"2020","author":"Obsa","year":"2020","journal-title":"Anesthesiol. Res. Pract."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1097\/EJA.0b013e328345a413","article-title":"Intraocular pressure and haemodynamic responses to insertion of the i-gel, laryngeal mask airway or endotracheal tube","volume":"28","author":"Ismail","year":"2011","journal-title":"Eur. J. Anaesthesiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/j.bja.2021.05.009","article-title":"Supraglottic airway, tracheal intubation, and neuromuscular block: Will the m\u00e9nage \u00e0 trois endure?","volume":"127","author":"Blobner","year":"2021","journal-title":"Br. J. Anaesth."},{"key":"ref_6","unstructured":"(2022, January 07). LMA Supreme\u2122 a Second Generation SAD with and Innovative Second Seal\u2122. Available online: https:\/\/www.lmaco.com\/sites\/default\/files\/31817-LMA-SecondSeal-A4-0214-LORES-fnl.pdf."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"432","DOI":"10.11622\/smedj.2016133","article-title":"Comparison of the clinical performance of i-gel, LMA Supreme and LMA ProSeal in elective surgery","volume":"57","author":"Liew","year":"2016","journal-title":"Singap. Med. J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1016\/S0002-9394(14)73195-2","article-title":"Measurement and relationship of subarachnoid pressure of the optic nerve to intracranial pressures in fresh cadavers","volume":"116","author":"Liu","year":"1993","journal-title":"Am. J. Ophthalmol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1007\/s12028-011-9606-8","article-title":"Optic nerve ultrasound for the detection of raised intracranial pressure","volume":"15","author":"Rajajee","year":"2011","journal-title":"Neurocrit. Care"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1704","DOI":"10.1007\/s00134-007-0797-6","article-title":"Ultrasonography of the optic nerve sheath may be useful for detecting raised intracranial pressure after severe brain injury","volume":"33","author":"Geeraerts","year":"2007","journal-title":"Intens. Care Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"239","DOI":"10.4103\/1658-354X.154693","article-title":"Noninvasive intracranial pressure monitoring via optic nerve sheath diameter for robotic surgery in steep trendelenburg position","volume":"9","author":"Shah","year":"2015","journal-title":"Saudi J. Anaesth."},{"key":"ref_12","unstructured":"Butterworth, I.V.J.F., Mackey, D.C., and Wasnick, J.D. (2013). Morgan & Mikhail\u2019s Clinical Anesthesiology, Mc Graw Hill. [5th ed.]."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1007\/s00464-017-5653-3","article-title":"Ultrasonographic optic nerve sheath diameter for predicting elevated intracranial pressure during laparoscopic surgery: A systematic review and meta-analysis","volume":"32","author":"Kim","year":"2018","journal-title":"Surg. Endosc."},{"key":"ref_14","first-page":"1241","article-title":"Ultrasonographic Assessment of Optic Nerve Sheath Diameter during Pediatric Laparoscopy Ultrasound","volume":"41","author":"Min","year":"2015","journal-title":"Med. Biol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1097\/ANA.0000000000000106","article-title":"Detection of elevated intracranial pressure in robot-assisted laparoscopic radical prostatectomy using ultrasonography of optic nerve sheath diameter","volume":"27","author":"Whiteley","year":"2015","journal-title":"J. Neurosurg. Anesthesiol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Yu, J., Hong, J.H., Park, J.Y., Hwang, J.H., Cho, S.S., and Kim, Y.K. (2018). Propofol attenuates the increase of sonographic optic nerve sheath diameter during robot-assisted laparoscopic prostatectomy: A randomized clinical trial. BMC Anesthesiol., 18.","DOI":"10.1186\/s12871-018-0523-7"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"930","DOI":"10.15537\/smj.2020.9.25349","article-title":"The effect of laryngoscope types on hemodynamic response and optic nerve sheath diameter. McCoy, Macintosh, and C-MAC video-laryngoscope","volume":"41","author":"Okyay","year":"2020","journal-title":"Saudi Med. J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1007\/s12630-014-0118-9","article-title":"Comparison of propofol and volatile agents for maintenance of anesthesia during elective craniotomy procedures: Systematic review and meta-analysis","volume":"61","author":"Chui","year":"2014","journal-title":"Can. J. Anaesth"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Geng, W., Chen, C., Sun, X., and Huang, S. (2021). Effects of sevoflurane and propofol on the optic nerve sheath diameter in patients undergoing laparoscopic gynecological surgery: A randomized controlled clinical studies. BMC Anesthesiol., 21.","DOI":"10.1186\/s12871-021-01243-7"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"393","DOI":"10.17085\/apm.2019.14.4.393","article-title":"Optic nerve sheath diameter changes during gynecologic surgery in the Trendelenburg position: Comparison of propofol-based total intravenous anesthesia and sevoflurane anesthesia","volume":"14","author":"Lee","year":"2019","journal-title":"Anesth. Pain Med."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Blecha, S., Harth, M., Schlachetzki, F., Zeman, F., Blecha, C., Flora, P., Burger, M., Denzinger, S., Graf, B.M., and Helbig, H. (2017). Changes in intraocular pressure and optic nerve sheath diameter in patients undergoing robotic-assisted laparoscopic prostatectomy in steep 45\u00b0 Trendelenburg position. BMC Anesthesiol., 17.","DOI":"10.1186\/s12871-017-0333-3"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s12028-014-0041-5","article-title":"Consensus summary statement of the international multidisciplinary consensus conference on multimodality monitoring in neurocritical care","volume":"21","author":"Le","year":"2014","journal-title":"Neurocrit. Care"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"51","DOI":"10.4103\/sni.sni_403_16","article-title":"Noninvasive monitoring intracranial pressure-A review of available modalities","volume":"8","author":"Khan","year":"2017","journal-title":"Surg. Neurol. Int."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"743","DOI":"10.3171\/2014.10.JNS141197","article-title":"Ultrasonographic measured optic nerve sheath diameter as an accurate and quick monitor for changes in intracranial pressure","volume":"123","author":"Maissan","year":"2015","journal-title":"J. Neurosurg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1016\/j.jclinepi.2010.02.005","article-title":"CONSORT 2010 Statement: Updated guidelines for reporting parallel group randomised trials","volume":"63","author":"Schulz","year":"2010","journal-title":"J. Clin. Epidemiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1186\/s12987-020-00201-8","article-title":"Review: Pathophysiology of intracranial hypertension and noninvasive intracranial pressure monitoring","volume":"17","author":"Canac","year":"2020","journal-title":"Fluids Barriers CNS"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/S0929-8266(02)00036-8","article-title":"Observer variation in the sonographic measurement of optic nerve sheath diameter in normal adults","volume":"15","author":"Ballantyne","year":"2002","journal-title":"Eur. J. Ultrasound"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1111\/j.1553-2712.2007.00031.x","article-title":"Correlation of optic nerve sheath diameter with direct measurement of intracranial pressure","volume":"15","author":"Kimberly","year":"2008","journal-title":"Acad. Emerg. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e1278","DOI":"10.1097\/CCM.0000000000004689","article-title":"A Prospective Study of Optic Nerve Ultrasound for the Detection of Elevated Intracranial Pressure in Severe Traumatic Brain Injury","volume":"48","author":"Agrawal","year":"2020","journal-title":"Crit. Care Med."},{"key":"ref_30","first-page":"1320","article-title":"Comparative Study of Hemodynamic Responses to Airway Maintenance Devices: Proseal LMA V\/S IGEL Airway","volume":"2","author":"Singh","year":"2014","journal-title":"JMSCR"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1111\/j.1399-6576.1994.tb03938.x","article-title":"The haemodynamic response to the insertion of the laryngeal mask airway: A comparison with laryngoscopy and tracheal intubation","volume":"38","author":"Wood","year":"1994","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1097\/EJA.0b013e32831a468d","article-title":"Cardiovascular responses to laryngoscopy and tracheal intubation are not accompanied by ST-segment changes","volume":"26","author":"Theodoraki","year":"2009","journal-title":"Eur. J. Anaesthesiol."},{"key":"ref_33","first-page":"9","article-title":"Comparison of endotracheal intubation, laryngeal mask airway, and I-gel in children undergoing strabismus surgery","volume":"28","author":"Allahyari","year":"2021","journal-title":"J. Res. Med. Sci."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"463","DOI":"10.15537\/smj.2019.5.24131","article-title":"Laryngeal mask airway for general anesthesia in interventional neuroradiology procedures","volume":"40","author":"Ozhan","year":"2019","journal-title":"Saudi Med. J."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"145","DOI":"10.5603\/AIT.2013.0030","article-title":"Anaesthetic management for endovascular treatment of unruptured intracranial aneurysms","volume":"45","author":"Karwacki","year":"2013","journal-title":"Anaesthesiol. Intensive"},{"key":"ref_36","first-page":"359","article-title":"Airway management in general anesthesia for endovascular treatment of cerebral arteriovenous malformation: A retrospective observational study","volume":"72","author":"Atik","year":"2022","journal-title":"Braz. J. Anesthesiol."},{"key":"ref_37","first-page":"434","article-title":"Are there predictive tests that determine the difficulty in Laryngeal Mask Airway Insertion?","volume":"71","author":"Kucukosman","year":"2021","journal-title":"J. Pak. Med. Assoc."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"634320","DOI":"10.1155\/2015\/634320","article-title":"Comparison of the proseal, supreme, and i-gel SAD in gynecological laparoscopic surgeries","volume":"2015","author":"Mukadder","year":"2015","journal-title":"Sci. World J."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/4\/753\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:14:40Z","timestamp":1760123680000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/4\/753"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,12]]},"references-count":38,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["medicina59040753"],"URL":"https:\/\/doi.org\/10.3390\/medicina59040753","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,12]]}}}