Comparison of Changes in Rso2 in Midazolam and Propofol Sedation Post Craniotomy in the Icu of H. Adam Malik Hospital

Dicko Kanugrahan Pratama, Rr Sinta Irina, Ade Winata


Introduction: Cerebral oxygen saturation reflects tissue perfusion in the cerebrum. Decreases in cerebral oxygen saturation are linked to longer hospital stays and cognitive impairment. Midazolam and propofol can decrease cerebral blood flow through decreasing the cerebral oxygen metabolic rate. The purpose of this research is to analyze the comparison of changes in cerebral oxygen saturation after midazolam and propofol administration in post-craniotomy patients in the ICU of Haji Adam Malik General Hospital Medan.
Subject and Method: This is a randomized control trial study. Patients were divided into, Midazolam group, that given an initial dose of 0.05 mg/kg followed by a maintenance dose of 0.02-0.10 mg/kg/hour and Propofol group that given sedation with a dose of 0.3-3mg/kg/hour, with the target of the 2 groups being a Richmond Agitation-Sedation Scale (RASS) value of 0 to -2. Data analysis using unpaired T test.
Results: The results for cerebral regional oxygen saturation and RASS between groups showed significant differences in right and left value (p < 0.001), but there was no significant difference in RASS (p>0.05) between each group at each measurement time. The results of the analysis of cerebral regional oxygen saturation and RASS between times, there was no significant difference in right and left value (p>0.05), but there was a significant difference in RASS (p<0.001) at each measurement time. Based on the results of the analysis carried out, it is known that there is no statistically significant difference in changes in cerebral regional oxygen saturation both right and left in changes in RASS because it is found that all data have p>0.05.
Conclusion: There is no change in right and left for cerebral regional oxygen saturation after administration of propofol and midazolam groups with RASS value 0 to -2 in post-craniotomy patients in the ICU of Haji Adam Malik General Hospital Medan


ICU, craniotomy, midazolam, propofol, cerebral regional oxygen saturation

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Valentino A, Endriani R, Ameini F. Gambaran kejadian pneumonia pada pasien pasca kraniotomi di ruang rawat intensif RSUD Arifin Achmad Provinsi Riau Periode Januari 2015 sampai Desember 2019. J Ilmu Kedokt 2021; 14(2): 111-20. Doi:–120.

Sumardi FS, Rahardjo S, Bisri T. Tatalaksana kraniektomi dekompresif pada pasien cedera otak traumatik berat yang disertai peningkatan tekanan tinggi intrakranial menetap. J. neuroanestesi Indones. 2018; 7(3): 185–97. Doi:

Badenes R, Prisco L, Maruenda A, Taccone FS. Criteria for intensive care admission and monitoring after elective craniotomy. Curr Opin Anaesthesiol. 2017; 30(5): 540–45. Doi: https://doi.org10.1097/ACO.0000000000000503

Worah S, Minokadeh A. Postoperative and intensive care including head injury and multisystem sequelae. 6th ed. Neuroanesthesia. Elsevier USA, 2017.

Gaus S. Pascaoperasi bedah saraf: Kapan ekstubasi, kapan ventilasi?. J. neuroanestesi Indones. 2013; 2(2): 123–34. Doi:

Ogawa Y, Iwasaki KI, Aoki K, Gokan D, Hirose N, Kato J, et al. The different effects of midazolam and propofol sedation on dynamic cerebral autoregulation. Anesth Analg. 2010; 111(5): 1279–284. Doi:

Miyagawa N, Kawazoe Y, Sato T, Kushimoto S, Miyamoto K, Ohta Y, Morimoto T,et al. Comparison between midazolam and propofol in acute phase for ventilated patients with sepsis: a post-hoc analysis of the DESIRE trial. Acute Med Surg. 2022; 9(1): 746. Doi:

Ghanem MA, Elemam K, Mousa SA, Youssef MY. Cerebral oxygenation and metabolism in patients undergoing clipping of cerebral aneurysm: A comparative study between propofol-based total intravenous anesthesia and sevoflurane-based inhalational anesthesia. Egypt J Anaesth. 2021; 37(1): 135–44. Doi:

Andriani A, Hartono R. Saturasi oksigen dengan pulse oximetry dalam 24 jam pada pasien dewasa terpasang ventilator di ruang ICU Rumah Sakit Panti Wilasa Citarum Semarang. JNJ. 2013; 2(1): 257–63. Doi:

Mustikarani A, Mustofa A. Peningkatan saturasi oksigen pada pasien stroke melalui pemberian posisi head up. Ners Muda. 2020; 1(2): 114-19. Doi:

Steiner LA, Pfister D, Strebel SP, Radolovich D, Smielewski P, Czosnyka. Near-infrared spectroscopy can monitor dynamic cerebral autoregulation in adults. Neurocrit Care. 2009; 10(1): 122–28. Doi: https//

Scheeren TWL, Schober P, Schwarte LA. Monitoring tissue oxygenation by near infrared spectroscopy (NIRS): Background and current applications. J Clin Monit Comput. 2012; 26 (4):279–87. Doi: https//

Laksono BH. Transcranial doppler ultrasonography: Diagnosis dan non-invasive monitoring in neuroanesthesia and neurointesive care. J Neuroanestesi Indones. 2017; 6(2): 124–31. Doi:

Festic E, Rawal B, Gajic O. How to improve assessment of balance in baseline characteristics of clinical trial participants-example from PROSEVA trial data?. Ann Transl Med. 2016; 4(4): 79. Doi:

Holmberg MJ, Andersen LW. Adjustment for baseline characteristics in randomized clinical trials. JAMA. 2022; 328(21): 2155–156. Doi:

Oddo M, Crippa IA, Mehta S, Menon D, Payen JF, Taccone FS, et al. Optimizing sedation in patients with acute brain injury. Crit Care. 2016;20(1):128. Doi: 10.1186/s13054-016-1294-5.

Froese L, Dian J, Batson C, Gomez A, Unger B, Zeiler FA. Cerebrovascular response to propofol, fentanyl, and midazolam in moderate/severe traumatic brain injury: A scoping systematic review of the human and animal literature. Neurotrauma Rep. 2020; 1(1): 100–12. Doi:

Tanguy M, Seguin P, Laviolle B, Bleichner JP, Morandi X, Malledant Y. Cerebral microdialysis effects of propofol versus midazolam in severe traumatic brain injury. J Neurotrauma. 2018; 29(6): 1105–10. Doi:



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