The Comparison of the Effectiveness of Additional Scalp Block Bupivacaine 0,125% with Bupivacaine 0,25% on Hemodynamic Responses in Patients Undergoing Craniotomy

Afprimadhona Afprimadhona, Rose Mafiana, Fredi Heru Irwanto, Ziske Maritska, Agung Muda Pati

Abstract


Introduction: Scalp block is one of the regional blocks that can be combined with neuroanesthesia in craniotomy of tumor resection (CTR) surgery. The advantages of scalp block can blunt the stress response during CTR, maintain hemodynamic stability, and reduce the use of opioid drugs during the operation.
Subject and Method: This study is a double-blinded randomized controlled trial. The subjects consisted of 28 samples aged 18-65 years, GCS 15, ASA II-III physical status, with a diagnosis of intracranial tumor who underwent CTR at Mohammad Hoesin Hospital, Palembang. The samples were divided into two treatment groups using general anesthesia techniques with the addition of a scalp block using bupivacaine 0.125% and bupivacaine 0.25%. Patients who were allergic to bupivacaine, those in hemorrhagic shock, or those had undergone surgery lasting more than 6 hours were excluded from data collection. Data analysis was conducted by assessing hemodynamic changes, namely systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and heart rate (HR). The data analysis methods used were the general linear model, specifically repeated measures ANOVA, paired t-test, and independent t-test with SPSS version 28.
Results: There is no significance difference between two group in the hemodynamic changes of systolic blood pressure (SBP), diastolic blood pressure (DBP), mean atrial pressure (MAP), and heart rate (HR) over time between the two groups using bupivacaine 0.125% and bupivacaine 0.25% with the independent t-test (p>0.05). The presence of significant hemodynamic changes in each treatment group over time with repeated-ANOVA and paired-t-test statistical tests (p<0.05). No side effects are observed. There is no significant proportional difference in the addition of fentanyl doses between the two groups (p>0.05).
Conclusion: The addition of a scalp block with 0.125% bupivacaine is equally effective as 0.25% bupivacaine in maintaining hemodynamic stability during tumor resection craniotomy surgery. The need for opioids during the intraoperative period can be reduced


Keywords


buvipacaine, hemodynamic, neuroanesthesia, scalp block, tumor removal craniotomy

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References


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DOI: https://doi.org/10.24244/jni.v14i3.647

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