Effects of Sedation Agents on Optic Nerve Sheath Diameter

This prospective observational study aims to evaluate the acute effects of ketamine and propofol sedation on optic nerve sheath diameter (ONSD) in adult patients undergoing procedural sedation in the emergency department. ONSD is a noninvasive ultrasonographic measurement that may reflect changes in intracranial pressure. Adult patients who receive intravenous ketamine or propofol for procedural sedation will be included. The sedative agent will be selected by the treating physician according to routine clinical practice, and patients will not be randomly assigned to treatment groups. ONSD will be measured using ocular ultrasonography before and after sedation. The primary purpose of the study is to compare changes in ONSD following ketamine and propofol administration and to evaluate whether these commonly used sedative agents have different effects on ONSD.

Inclusion Criteria: * Age 18 years or older. * Underwent intravenous sedation with ketamine or propofol in the emergency department for fracture or dislocation reduction. * Underwent intravenous sedation with ketamine or propofol in the emergency department for chest tube placement. * Underwent intravenous sedation with ketamine or propofol in the emergency department for imaging. * Underwent intravenous sedation with ketamine or propofol in the emergency department for gastrointestinal endoscopy. * Had no ocular disease or intracranial pathology. * Provided informed consent to participate in the study. Exclusion Criteria: * Did not provide informed consent. * Could not undergo optic nerve sheath diameter (ONSD) measurement because of inability to cooperate with ocular ultrasonography.