scholarly journals A comparative study of hemodynamic changes in dexmedetomidine versus midazolam and fentanyl combination during awake fibreoptic intubation

2021 ◽  
Vol 12 (11) ◽  
pp. 113-118
Author(s):  
Ritu Baloda ◽  
Jaspreet Kaur ◽  
Rupali Battu ◽  
Sudha Puhal
Keyword(s):  
Blood Pressure ◽  
Fibreoptic Intubation ◽  
Hemodynamic Changes ◽  
Group I ◽  
Significant Difference ◽  
The Mean ◽  
Post Intubation ◽  
Excessive Sedation ◽  
Fentanyl Group ◽  
Stimulation Of

Background: The hemodynamic changes during awake fibreoptic intubation (AFOI) are attributed to patient’s anxiety, poor topicalization of the airway, excessive sedation, lack of expertise, pain, prolonged time to intubation, stimulation of oropharyngeal structures, and jaw thrust to aid intubation. In this study, we compared hemodynamic changes of dexmedetomidine (DEX) with midazolam (MDZ) and fentanyl during AFOI. Aims and Objectives: The objective of the study is to compare the hemodynamic changes in DEX alone versus fentanyl- MDZ combination during AFOI. Materials and Methods: Group-I patients (n=30) received DEX 1 μg/kg bolus infusion over 10 min, followed by infusion of 0.1 μg/kg/h titrated to 0.7 μg/kg/h whereas Group-II patients (n=30) received iv fentanyl 2 μg/kg bolus followed by MDZ infusion of 0.02–0.1 mg/kg/h until they were adequately sedated, i.e. Ramsay Sedation Score (RSS) of 3. Hemodynamics including heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), oxygen saturation (SpO2) were recorded when patient is sedated, i.e. at RSS-3, every min of fibrescopy till 5 min and at intubation and every 3rd min post-intubation till 30 min. Results: Measurements of the HRs in the two groups showed significant differences between the two groups at RSS-3, during FOS and post-intubation with the DEX group showing lower mean HRs compared with the MDZ and fentanyl group. SBP and DBP showed a fall in both the groups as compared with the baseline at RSS-3, during FOS and post-intubation; however, no significant differences were noted between the two groups. The mean SpO2values show significant difference between the two groups. (P<0.05) at RSS-3, FOS, post intubation upto 18 min (P<0.05). Conclusion: The use of DEX at 1 mcg/kg bolus slowly over 10 min, with maintenance rates of 0.1–0.7 μg/kg/h, is safe and beneficial for patients undergoing AFOI. Thus, DEX acts like an ideal drug for AFOI. It provides excellent intubating conditions without significant hemodynamic perturbations and risk of hypoxia.

scholarly journals Comparative evaluation of fentanyl versus nalbuphine for attenuation of hemodynamic changes during airway stimulation

2018 ◽  
Vol 6 (2) ◽  
pp. 632
Author(s):  
Aqusa Buchh ◽  
Kumkum Gupta ◽  
Deepak Sharma ◽  
Usman Anwar ◽  
Mahesh Narayan Pandey ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Study Drug ◽  
Hemodynamic Changes ◽  
Group I ◽  
Significant Difference ◽  
Primary Variable ◽  
To Receive ◽  
Fentanyl Group ◽  
Mean Heart Rate

Background: Airway stimulation predictably leads to variable hemodynamic changes which can be modified by opioid premedication. The present study was aimed to compare the clinical efficacy of fentanyl with nalbuphine on hemodynamic changes during airway stimulation.Methods: Sixty adult patients of ASA physical status I and II of either gender, were randomized into two groups of 30 patients each to receive either fentanyl 2µg/kg, Group I or nalbuphine 0.2mg/kg, Group II, 10min before induction with propofol. Direct laryngoscopy and intubation was facilitated with vecuronium bromide. Heart rate, blood pressure and ECG were recorded at baseline, after giving study drug, at intubation and then after at 1st, 2nd, 3rd, 5th, 10th and 15th minutes after intubation and noted as primary variable. Any adverse effects and complications were recorded as secondary end points.Results: After premedication, the fall in heart rate was comparable between the groups. The fall in mean blood pressure showed statistically significant difference between the groups. After induction, there was further decrease in heart rate and blood pressure with statistically significant difference. After laryngoscopy and intubation, the increase in mean heart rate and blood pressure occurred immediately in patients of nalbuphine group and persisted up to 1to 2min while this increase persisted up to 5 to 7min in fentanyl group. The differences in hemodynamic changes between the groups were statistically significant.Conclusions: Nalbuphine (0.2mg/kg) could effectively attenuate the hemodynamic changes during airway stimulation when compared to fentanyl (2µg/kg), when given 10 minutes before induction.

Comparative study of two supraglottic airway devices- LMA Supreme and I-Gel in adult patients undergoing general anaesthesia at a tertiary hospital

2021 ◽  
Vol 17 (3) ◽  
pp. 141-145
Author(s):  
Shaikh Noorulhaque Mohammad Shafi ◽  
Keyword(s):  
General Anaesthesia ◽  
Airway Device ◽  
Supraglottic Airway ◽  
Supraglottic Airway Device ◽  
Hemodynamic Changes ◽  
Dental Injury ◽  
Group I ◽  
Significant Difference ◽  
The Mean ◽  
Lma Supreme

Background: The LMA Supreme is a supraglottic airway device made of medical grade PVC and is latex-free. The I-Gel is a new supraglottic airway device with a non-inflatable cuff, composed of soft gel like, transparent thermoplastic elastomer. The main aim of present study was to compare the LMA Supreme with the I-Gel LMA in terms of the success of insertion of the device, hemodynamic changes and postoperative device related complications. Material and Methods: Present study was a prospective, randomized, comparative, observational study conducted in patients admitted for various elective surgeries, were randomly divided (by envelope selection) as I-Gel LMA and Supreme LMA insertion for general anaesthesia. Results: The mean age in group I and S were 41.26 ± 10.22 and 44.86 ± 10.1 years respectively. The mean body weight in Group I was 55.51 ± 9.61 kgs and in Group S it was 53.12 ± 9.65 kgs. There was no significant difference in the age, gender, body weight, ASA Grades of the patients between Group 1 and Group 2 .Statistically there was no significant difference in the SAD Sizes, Surgical Procedures, ease of insertion in both the groups. The basal heart rate was, mean SBP, mean basal DBP, mean basal MAP and mean SpO2 were comparable in both groups. Blood Tinged SAD was noted in 6 patients in both group I (I-Gel) and group S (SLMA). None of the patients in group I (I-Gel) out of 43 patients had Lip or Dental Injury, whereas 2 patients in group S (SLMA) out of 43 patients had Lip or Dental Injury. Only 4 of the patients in group I (I-Gel) out of 43 patients had Sore Throat within 24 hours post removal of SAD, whereas 6 patients in group S (SLMA) out of 43 patients had Sore Throat within 24 hours post removal of SAD. Conclusion: Both LMA Supreme and I-Gel can be used effectively and comfortably in selected adult patients during general anaesthesia. Both LMA Supreme and I-Gel are easy to insert, both are almost inserted in first attempt, no significant difference in hemodynamic changes during usage is noted.

Immersive and Non-Immersive Virtual Reality Distraction on Pain Perception to Intraoral Injections

2021 ◽  
Vol 45 (6) ◽  
pp. 389-394
Author(s):  
Supriya Kumari ◽  
Rachana Bahuguna ◽  
Nishita Garg ◽  
Ramakrishna Yeluri
Keyword(s):  
Virtual Reality ◽  
Pain Perception ◽  
Dental Treatment ◽  
Immersive Virtual Reality ◽  
Dental Procedures ◽  
Group I ◽  
Significant Difference ◽  
The Mean ◽  
Group Ii ◽  
Chi Square Analysis

Objective: To evaluate the efficacy of immersive VR (IVR) and non-immersive VR (NIVR) distraction on perceived pain during intraoral injections in children undergoing dental procedures. The objective was to introduce 3-dimensional nature of virtual reality during the provoking phase of dental treatment as a means of distraction in children. Study design: A total of 200 children were selected for the study, 100 for IVR group and 100 for NIVR group. After randomization, children were introduced to Oculus Go Standalone equipment; MCDAS (f), VAS, WBFRS and the treatment procedure using tell show do technique. Group I children were introduced to oculus go standalone headset with hand held controller to play temple run or roller coaster game while in group II, children watched cartoon movies of their choice. Pre-operative & post-operative MCDAS scores were obtained using MCDAS (f) questionnaire in local language. Post-operatively, VAS and WBFRS scores were also obtained. The data was analyzed using independent t-test and chi-square analysis. Results: Pre-operatively, the mean MCDAS scores were similar in both the groups viz. Group–I (29.20 ± 3.197) and Group–II (29.09 ± 3.803) and is statistically not significant. Post-operatively, the mean MCDAS scores were higher in non-immersive group (20.72 ± 2.822) as compared to immersive group (10.99 ± 2.227). VAS score was higher in non-immersive group (2.72 ± 0.99) as compared to immersive group (0.75 ± 0.88). WBFRS scores were higher in non-immersive group (2.78 ± 1.097) as compared to immersive group (0.82 ± 1.104). Conclusion: Three-dimensional virtual reality was found to be an effective means of distraction in children undergoing dental procedures and especially during the provoking phase. The significant difference obtained clearly indicates irrespective of immersiveness of virtual reality, anxiety had been decreased and on comparison the pain perception to intraoral injection is less in immersive virtual reality environment. Immersive VR distraction technique can serve as an adjunct to traditional behavior management strategies already available to the pediatric dentist.

Two Types of Anesthesia and Hemodynamic Changes in Patients Over 60 Years of Age Who Need Artificial Femoral Head Replacement: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Weiqi Ke ◽  
Yuting WANG ◽  
Xukeng GUO ◽  
Ronghua HUANG ◽  
Xiangdong ZHANG ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Femoral Head ◽  
Elderly Patients ◽  
The Elderly ◽  
Hemodynamic Changes ◽  
Medical College ◽  
Replacement Surgery ◽  
Elder Patients ◽  
Significant Difference ◽  
And Gender

Abstract Background:Artificial femoral head replacement is one of the most effective methods for treatment of severe diseases of femoral joint in the elderly. The ideal anesthetic effect is one of the key elements for the success of the operation because it brings fast recovery. However, the multiple comorbidities of the elder patients make them too weak to tolerate the hemodynamic changes after anesthesia. In this case, the most suitable anesthesia method for patients undergoing femoral head replacement surgery is of great significance.Objective:To compare the post-anesthetic hemodynamic changes between combined lumbar plexus and sciatic nerve block(CLPSB) and combined spinal and epidural anesthesia(CSEA) in elderly patients undergoing unilateral artificial femoral head replacement.Methods:We reviewed records of the patients who aged over 60 years old (age 62-103 years) and received unilateral artificial femoral head replacement between January 2015 and December 2020 in the first affiliated hospital of Shantou University Medical College. After adjustment according to the inclusion criteria, 477 patients were included and divided into CLPSB group (n=90) and CSEA group (n=387). The primary outcome was comparison of the hemodynamic changes after anesthesia, including the systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and heart rate (HR). The second outcome was the comparison of the vasopressor used during the surgery.Results:We established three models to compare the two anesthesia methods on hemodynamic changes. Crude model included all variates for analysis, while model I adjusted age and gender. Model II adjusted other comorbidities in addition to model I. All three models exhibit that changes of MAP (∆MAP) after CSEA were higher than that after CLPSB(β= 6.88, 95% CI: 4.33 - 9.42, P < 0.0001), with significant difference, which indicated that CSEA causes higher fluctuation of MAP. Concurrently, the use of vasopressors increased by 137% (OR=2.37, 95%CI: 1.24-4.53, P=0.0091) in the CSEA group, which is statistically significant. However, the changes of HR (∆HR) between the CLPSB and CSEA was not significant(β= 0.50, 95% CI: 1.62 - 2.62, P = 0.6427). Conclusions:Both CLPSB and CSEA are ideal anesthesia methods for patients receiving femoral head eplacement, though CLPSB is more suitable for elderly patients with advanced hemodynamic stability.

scholarly journals EFFECTIVENESS OF HANDS OFF VERSUS HANDS ON TECHNIQUES ON PERINEAL TRAUMA AND PERINEAL PAIN AMONG PARTURIENT MOTHERS

2016 ◽  
Vol 9 (6) ◽  
pp. 179 ◽  
Author(s):  
Jayabharathi Bhaskaran
Keyword(s):  
Sampling Technique ◽  
Simple Random Sampling ◽  
Perineal Trauma ◽  
Perineal Pain ◽  
Study Group ◽  
Perineal Tear ◽  
Group I ◽  
Significant Difference ◽  
Hands On ◽  
The Mean

Background:  Labor is the process by which the fetus and the placenta leave the uterus. Delivery can occur in two ways, vaginally or by a cesarean delivery. The majority of women who have a vaginal birth will sustain perineal trauma from a spontaneous perineal tear or episiotomy or both.Aim: This study aims to assess the effectiveness of hands off versus hands on techniques on perineal trauma and perineal pain among parturient mothers in selected hospitals, Kerala.Methods: The research design adopted in this study was true experimental post test only design. The study was conducted in 3 hospitals at Kerala such as Karothukuzhiyil hospital Pvt, Lakshmi hospital Pvt and Carmal hospital Pvt. Sample size was computed by power analysis based on the previous studies and it would be a total of 90 samples, with 30 parturient mothers in each groups. Simple random sampling technique (Lottery method) was adopted for the selection of parturient mothers into the study. Perineal trauma was assessed by the scale given by Royal College of Obstetrics and Gynaecology (RCOG), 2001, and visual analogue scale (Combined numerical and categorical pain scale) was used to assess the perineal pain of parturient mothers.Results:  The results showed that, there was extremely significant difference found in perineal trauma and perineal pain of parturient mothers between study group I and study II at  p=0.000 level. The mean scores of study group I was lesser than the mean scores of study group II. Conclusion: Different perineal techniques and interventions such as hands on technique, hands off technique, perineal massage, warm compresses etc can be widely used by midwives and birth attendants to prevent perineal trauma during labour.  Key words:  hands off  technique, hands on technique, perineal trauma and perineal pain

scholarly journals THE EFFECT OF DEXAMETHASONE ON SPERMATOGONIUM AND SERTOLI CELL OF IPSILATERAL TESTIS IN UNILATERAL TESTICULAR TORSION WISTAR RAT

2018 ◽  
Vol 25 (2) ◽  
Author(s):  
Ferdyan Rachmat Efendi ◽  
Johan Renaldo ◽  
Tarmono Djojodimedjo
Keyword(s):  
Body Weight ◽  
Sertoli Cell ◽  
Sertoli Cells ◽  
Testicular Torsion ◽  
Wistar Rat ◽  
Male Rats ◽  
Sham Operation ◽  
Group I ◽  
Significant Difference ◽  
The Mean

Objective: To investigate the effect of dexamethasone on spermatogonium and sertoli cell of ipsilateral testis in unilateral testicular torsion strain wistar rat. Material & Method: Experimental study with post-test only control group design. The present  study was conducted on 30 Wistar male rats aged 10 – 12 weeks grouped into 5 groups. Group I was the normal/sham operation group (KN), group II was left testicular torsion for 4 hours group and followed  by manual detorsion  (K1), group III was left testicular torsion for 10 hours group and followed  by manual detorsion (K2),  group IV was left testicular torsion for 4 hours group and given dexamethasone 10 mg/kg body weight subcutaneously 30 minutes before manual etorsion (D1), and group V was left testicular torsion for 10 hours group and  given dexamethasone 10 mg/kg body weight subcutaneously 30 minutes before manual detorsion. All rats had left orchidectomy 4 hours after detorsion. The number of spermatogonium and sertoli cells were counted in histological seminiferous tubular testis that have obtained Haematoxylin Eosin staining. Data were analyzed by ANNOVA followed by Post Hoc Tukey for spermatogonium and Kruskal Wallis followed by Mann Whitney test for sertoli cell. Differences were considered significant at p <0.05. Results: There was significant difference in the mean number of spermatogonium between K1 & D1 group. Otherwise, there was no significant difference in the mean number of spermatogonium between K2 & D2. There was significant difference in the mean number of Sertoli cells between K1 & D1 group, likewise that between K2 & D2 group. Conclusion: These results suggest that dexamethasone has protective effect in spermatogonium and sertoli cell in testicular torsion for 4 hours.

scholarly journals Comparison of Ropivacaine-Fentanyl with Bupivacaine-Fentanyl for Labour Epidural Analgesia

2020 ◽  
Vol 14 (1) ◽  
pp. 108-114
Author(s):  
Kalpana Kulkarni ◽  
Rahul Patil
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Epidural Analgesia ◽  
Diastolic Blood Pressure ◽  
Diastolic Pressure ◽  
Vas Score ◽  
Group I ◽  
Significant Difference ◽  
Labour Epidural Analgesia ◽  
Group Ii

Background: Bupivacaine with opioid is commonly used for labour epidural analgesia. Ropivacaine is considered as an alternative to bupivacaine due to its lower cardiovascular complications. However, there is a controversy regarding the efficacy of these drugs as some studies suggest equivalent action, whereas others report that ropivacaine produces less motor blockade. The study aimed to compare the effect of ropivacaine-fentanyl and bupivacaine-fentanyl for labour analgesia. Materials and Methods: The prospective randomized study was performed on 60 parturients, divided into two groups of 30 subjects each. Group I received 10ml of bupivacaine 0.1% + fentanyl 2µg/ml and Group II received 10ml of ropivacaine 0.1% + fentanyl 2µg/ml by epidural catheter. Pre-anaesthetic evaluation was performed on all the participants and all were administered metoclopramide 0.25mg/kg and ondansetron 0.08-0.1mg/kg intravenously as premedication. The baseline and post anaesthesia systolic, diastolic blood pressure, heart rate, VAS score, degree of motor block, sedation and APGAR score of the baby were recorded. The data were tabulated and statistically analyzed. Results: When compared, there was no significant difference in systolic/diastolic blood pressure in two groups except at 360 min where diastolic pressure was low in group II. Significantly higher heart rate at 30 min (P=0.0003), 120 min (0.006), and 300 min (P=0.001) was observed in group I subjects. VAS score was significantly less at 180 min (P=0.019) and 300 min (P=0.019) in group II. Adverse effects such as fetal bradycardia, nausea/vomiting and hypotension observed were clinically insignificance when compared in two groups. Conclusion: Bupivacaine and ropivacaine produce an equal degree of analgesia and hemodynamic stability in 0.1% of concentration when added with 2µg/ml fentanyl . However, heart rate was well maintained with lower VAS scores in group II receiving ropivacaine. No significant difference in the side effects between the two groups. Hence, Ropivacaine can be used as a safe alternative to bupivacaine for labour epidural analgesia.

scholarly journals Comparitive evaluation of different concentrations of alcohol in ultrasound guided coeliac plexus neurolysis for pain relief in upper abdominal malignancies

2021 ◽  
Vol 8 (4) ◽  
pp. 492-500
Author(s):  
Manish Kumar Singh ◽  
Pragya Verma ◽  
Sarita Singh ◽  
Gyan P Singh ◽  
Hemlata Verma
Keyword(s):  
Quality Of Life ◽  
Morphine Consumption ◽  
Rescue Analgesia ◽  
Vas Score ◽  
Group I ◽  
Significant Difference ◽  
The Mean ◽  
Group Ii ◽  
Upper Abdominal

Patients suffering from advanced upper abdominal malignancies have pain as predominant symptom affects their quality of life and survival. USG guided coeliac plexus neurolysis become benevolence in these patients on part of their pain management and quality of life improvement. To compare the efficacy of USG guided coeliac plexus neurolysis for pain relief in upper abdominal malignancies by using different concentration of alcohol (50% vs 75%).This Prospective, comparative, randomised double blinded study was conducted during Sep 2019 – Aug 2020 at our tertiary care centre. Total 60 cases were taken as per following inclusion and exclusion criteria and randomly divided into 2 groups i.e. 30 each group, we compare Visual Analogue Scale (VAS) score, quality of life (QOL) and need of rescue analgesia profile between the groups to know the efficacy of USG guided coeliac plexus block. In our study, we observed that the baseline mean VAS score in group I was 8.26±0.78 while in group II was 8.03±0.76. No significant difference was found in mean VAS score at this time between the groups (p=0.24). The baseline mean QOL score in group-I was 77.46±3.40 while for the cases of group II the mean QOL score was 77.36±3.33. No significant difference was found in mean QOL score at baseline between the groups (p=0.90). The baseline mean morphine consumption in group-I was 113.33±39.24 mg while for the cases of group-II the mean morphine consumption was 120.33±38.37mg. No significant difference was found in mean morphine consumption at this time between the groups (p=0.48).Both groups having 50% alcohol and 75% alcohol decreases the VAS score from baseline in patients having upper abdominal malignancies along with QOL and dosages of rescue analgesia whereas no significant difference in VAS score in patients of both groups.

scholarly journals TO STUDY THE ONSET AND PROGRESSION OF AIRWAY ABNORMALITY IN TERMS OF ALTERATION IN PFT IN ASYMPTOMATIC SMOKERS.

2019 ◽  
Vol 3 (11) ◽  
Author(s):  
Dr. Hitesh Kumar Solanki ◽  
Dr. Omnath P Yadav ◽  
Dr. Anita J Gojiya
Keyword(s):  
Lung Function ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Medical College ◽  
Group I ◽  
Significant Difference ◽  
History Of ◽  
Young Smokers ◽  
The Mean ◽  
Group Ii

The study was conducted in department of physiology, B J Medical College, Ahmedabad from Mar. 2012 to Feb. 2013. This was a cross-sectional study to evaluate the effect of smoking on lung   function and serum lipids in asymptomatic smokers   and comparable non   smokers. The mean of the various spirometric parameters were calculated of the subjects for both the groups. The mean FVC in group I and group II was 2.60 ± 0.62 L and 4.10 ± 0.64L respectively. The mean FEV1 in group I was 1.91 ± 0.57L and     3.19 ± 0.77L in group II Group I had mean FEF25% - 75% and PEFR of 1.98 ± 0.67L/sec and 4.50 ± 1.57L/sec respectively. Group II had mean FEF25 – 75% of 4.22 ± 1.23L/sec and a mean PEFR of 7.22 ± 1.42L/sec. In young smokers and asymptomatic, still the spirometric values were significantly deranged as compared to controls. Even smokers with history of less pack years of smoking also had significant abnormalities of lung function. All he spirometric values in the two groups had statistically highly significant difference and were higher in non-smokers as compared to smokers. The spirometric values were reduced in smokers with history of smoking for as low as two pack years. Keywords: Progression, PFT, Asymptomatic & Smokers

scholarly journals Perbedaan Respon Hemodinamik dengan Penambahan Blok Scalp Levobupivakain pada Operasi Kraniotomi

2020 ◽  
Vol 9 (1) ◽  
pp. 8-15
Author(s):  
Arya Justisia Sani ◽  
Ardhana Tri Arianto ◽  
Muhammad Husni Thamrin
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Hemodynamic Response ◽  
Anesthesia Induction ◽  
Group I ◽  
Significant Difference ◽  
Scalp Block ◽  
One Way Anova

Latar Belakang dan Tujuan: Peningkatan respon hemodinamik yang disebabkan oleh nyeri dapat menyebabkan peningkatan aliran darah otak dan tekanan intrakranial. Blok scalp pada kraniotomi menumpulkan respon hemodinamik karena rangsangan nyeri serta mengurangi penambahan analgesi lain. Penelitian ini bertujuan untuk mengetahui efektifitas blok scalp sebagai analgetik pada kraniotomi.Subjek dan Metode: Penelitian ini menggunakan uji klinik acak tersamar ganda pada 36 pasien dengan status fisik ASA 1–3 dilakukan operasi kraniotomi eksisi dan memenuhi kriteria inklusi. Sampel dibagi menjadi kelompok I (dengan blok scalp) dan kelompok II (tanpa blok scalp). Blok dilakukan sesaat setelah induksi anestesi. Digunakan levobupivakain 0,375% sebanyak 3 ml tiap insersi, pada masing-masing saraf. Tekanan darah, tekanan arteri rata-rata, detak jantung sebelum intubasi dan setelah intubasi, pemasangan pin, insisi kulit dan insisi duramater serta total kebutuhan fentanyl tambahan dicatat. Data yang diperoleh dianalisis dengan program komputer SPSS versi 17 lalu diuji menggunakan uji Kruskal-Wallis atau One-way ANOVA. Batas kemaknaan yang diambil adalah p < 0,05.Hasil: Selama kraniotomi, detak jantung, tekanan darah, tekanan arteri rata-rata secara signifikan lebih tinggi pada pasien tanpa blok scalp terutama pada saat pemasangan pin. Hasil uji statistik menunjukkan perbedaan signifikan, penambahan fentanyl pada pasien dengan blok scalp lebih sedikit dibandingkan tanpa blok scalp, p=0,000 (p<0,05).Simpulan: Blok scalp levobupivakain efektif dalam menurunkan respon hemodinamik terutama pada saat pemasangan pin. Pasien kraniotomi dengan blok scalp membutuhkan penambahan fentanyl lebih sedikit. Differences on Hemodynamic Response with Levobupivacaine Scalp Block in Craniotomy SurgeryAbstractBackground and Objective: Increased hemodynamic response caused by pain can lead to increased cerebral blood flow and intracranial pressure. Scalp block in craniotomy blunts hemodynamic response due to pain and reduce other analgesics addition. This study aims to determine effectiveness of scalp blocks as analgesic in craniotomy.Subject and Method: This study used a double-blind randomized clinical trial in 36 patients with physical status ASA 1-3 who underwent craniotomy and met inclusion criteria. Samples were divided into group I (with scalp block) and group II (without scalp block). Scalp Block was performed right after anesthesia induction. Using levobupivacaine 0.375% 3 ml for each insertion. Blood pressure, mean arterial pressure, heart rate before and after intubation, during pin placement, skin incision and duramater incision and total need for additional fentanyl were recorded. SPSS version 17 was used and data were analysed using Kruskal-Wallis or One-way ANOVA. Statistical significance was accepted at p < 0.05.Result: During craniotomy, heart rate, blood pressure, mean arterial pressure were significantly higher in patients without scalp block especially during pin placement. Statistical test showed significant difference, additional fentanyl in patients with scalp blocks was lesser, p = 0.000 (p <0.05). Conclusion: Levobupivacaine scalp block was effective to blunt hemodynamic response especially during pin placement. Scalp block also decreased additional fentanyl in craniotomy.

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