scholarly journals Peran blok servikal superfisialis pada timpanomastoidektomi dalam anestesia umum

2015 ◽  
Vol 45 (1) ◽  
pp. 1
Author(s):  
Pryambodho Pryambodho ◽  
Ruth Evlin Margaretha ◽  
Aida Rosita Tantri ◽  
Harim Priyono

Pendahuluan: Blok perifer yang digunakan saat pasien teranestesi akan mengurangi kebutuhan anestesia dan analgesia selama pembedahan. Berkurangnya pemakaian opioid intraoperatif juga akan mengurangi morbiditas pascaoperatif yang berkaitan dengan opioid. Tujuan: Penelitian dilakukan untuk mengetahui peran Blok Pleksus Servikal Superfisialis (BPSS) dalam mengurangi konsumsi fentanil intraoperatif, menstabilkan hemodinamik intraoperatif, dan mempercepat waktu pulih pada timpanomastoidektomi dalam anestesia umum. Metode: Penelitian ini merupakan uji klinis acak tersamar tunggal yang dilakukan di RSCM selama bulan September-November 2013 pada 32 pasien usia 19-65 tahun, ASA I-III dengan berat badan 35-80 kg yang dibagi menjadi dua kelompok. Hasil: Pada kelompok BPSS, dilakukan BPSS sebelum induksi menggunakan bupivakain 0,5%, sedangkan pada kelompok kontrol tidak dilakukan. Anestesia dipertahankan dengan FGF 0,8-1,6 lpm, compress air: O2 (konsentrasi 40%); isofluran ±1 MAC dan atrakurium 0,25 mg/kgBB setiap 30 menit untuk menjaga nilai BIS 45-60. Fentanil diberikan setiap ada peningkatan tekanan darah sistolik atau frekuensi nadi ≥20% dari nilai 5 menit sebelumnya. Saat 30 menit sebelum operasi selesai diberikan parasetamol 1 gram iv dan ondansetron 4 mg iv. Rerata konsumsi fentanil intraoperatif, tekanan darah sistolik, dan frekuensi nadi kelompok BPSS lebih rendah dan bermakna secara statistik dibandingkan kelompok kontrol: 150 mcg vs 262,5 mcg, p<0,001; 104 (90-112) vs 120 (110-130), p<0,001 dan 68 (62-86) vs 80 (68-100), p<0,001. Kesimpulan: Pemberian blok pleksus servikal superfisialis sebelum induksi mengurangi konsumsi fentanil intraoperatif, menekan respon hemodinamik terhadap insisi kulit, dan mempercepat waktu pulih pada timpanomastoidektomi dalam anestesia umum. Kata kunci: anestesia umum, blok pleksus servikal superfisialis, kecepatan waktu pulih, konsumsi fentanil, timpanomastoidektomiABSTRACT Background: The peripheral block combined with general anesthesia reduces intraoperative anesthesia and analgesia requirement. Reduced opioid consumption decreases postoperative morbidity related to opioid. Purpose: The aim of this study was to assess the role of superficial cervical plexus block (SCPB) before induction in reducing fentanyl consumption, stabilizing intraoperative hemodynamic, and speeding up recovery time in tympanomastoidectomy.  Methods: This single blind randomized clinical trial was conducted in RSCM from September to November 2013 on 32 ASA I-III patients, 13-65 years old, with body weight range 35-85 kg which were randomized into 2 groups. Result: SCPB was performed in SCPB group before induction using bupivacaine 0.5%, whereas in the control group was not performed. Anesthesia was maintained with FGF 0,8-1,6 lpm, compress air: O2 with O2 consentration 40%, isoflurane ± 1 MAC, and atracurium 0,5 mg/kgBW every 30 minutes to keep BIS level 45-60. Fentanyl was given when there was an increase in systolic blood pressure or pulse rate ≥20% more than the value of 5 minutes previously. Paracetamol 1 g iv and ondansetron 4 mg iv were given 30 minutes before the end of the surgery. The average intraoperative fentanyl consumption, systolic blood pressure, and pulse rate was lower and statistically significant in BPSS group compared to the control group: 150 mcg vs 262,5 mcg, p<0,001; 104 (90-112) vs 120 (110-130), p<0,001 and 68 (62-86) vs 80 (68-100), p<0,001 Conclusion: Administration of SCBP before induction, reduced the intraoperative fentanyl consumption, suppressed hemodynamic responses to skin incision and speed up recovery time on tympanomastoidectomy in general anesthesia. Keywords: general anesthesia, superficial cervical plexus block, recovery time, fentanyl consumption,tympanomastoidectomy

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e034003
Author(s):  
Kun Peng ◽  
Min Zeng ◽  
Jia Dong ◽  
Xiang Yan ◽  
Dexiang Wang ◽  
...  

IntroductionScalp nerve block has been proven to be an alternative choice to opioids in multimodal analgesia. However, for the infratentorial space-occupying craniotomy, especially the suboccipital retrosigmoid craniotomy, scalp nerve block is insufficient.Methods and analysisThe study is a prospective, single-centre, randomised, paralleled-group controlled trial. Patients scheduled to receive elective suboccipital retrosigmoid craniotomy will be randomly assigned to the superficial cervical plexus block group or the control group. After anaesthesia induction, superficial cervical plexus nerve block will be performed under the guidance of ultrasound. The primary outcome is the cumulative consumption of sufentanil by the patient-controlled intravenous analgesia pump within 24 hours after surgery. Secondary outcomes include the cumulative consumption of sufentanil at other four time points and numerical rating scale pain severity score.Ethics and disseminationThe protocol (version number: 2.0, 10 April 2019) has been approved by the Ethics Review Committee of China Registered Clinical Trials (Ethics Review No. ChiECRCT-20190047). The findings of this study will be disseminated in peer-reviewed journals and at scientific conferences.Trial registration numberNCT04036812


Author(s):  
Nedumaran Velayutham ◽  
Selvaraju . ◽  
Shanmugavelu .

Background: When general anaesthesia is employed for a surgery, the hemodynamic changes are intense during intubation, intraoperative stress and extubation. Hence, in the present study, by employing Bilateral Superficial Cervical Plexus Block using 0.5% Bupivacaine prior to skin incision, assessment of hemodynamic effects during intraoperative period is done. The aim of the study was to compare the intra operative hemodynamic status and the safety of bilateral superficial cervical plexus block with general anesthesia in thyroid surgerie.Methods: Bilateral superficial cervical plexus block was performed in patients undergoing simple thyroid surgery using normal saline in 29 control group patients and 0.5% Bupivacaine in 29 study group patients. Intraoperative hemodynamic status was monitored in both the groups using parameters such as heart rate, systolic blood pressure, diastolic blood pressure and mean blood pressure.Results: Hemodynamic parameters are not altered during the intraoperative period in the study and control group.Conclusions: Bilateral Superficial Cervical Plexus Block with bupivacaine did not alter the intraoperative hemodynamic parameters.


2020 ◽  
Vol 4 (3) ◽  
pp. 826-830
Author(s):  
Vivek Singh ◽  
Bijay KC ◽  
Ritesh Giri ◽  
Prachi Bhagat

Introduction: Methods for lessening the sensation of pain during surgery date back to ancient times. Although general anesthesia is preferred over locoregional anesthesia in incision and drainage  of space infection in neck region, it is expensive, with increased morbidity and mortality. Sometimes, anesthetist experienced in fiber optic-guided nasal intubation may be required due to reduced mouth opening. Hence, in such cases and poor risk patients, Superficial Cervical Plexus Block  can be used in association with trigeminal V3 local anesthesia. Objective: To evaluate the efficacy of Superficial Cervical Plexus Block in incision and drainage of submandibular and submental space infection. Methodology: A prospective clinical study was carried out at Nobel Medical College and Teaching Hospital, Biratnagar, Nepal from June 2018 to May 2019 suffering from submandibular and submental space infection arising from odontogenic causes who required incision and drainage. Pain response was measured using Visual Analogue Scale. Result: Out of Twenty four patients sixteen were female and 8 were male. The age ranged from 16 to 82 years with a mean age of 40.5±18.53. The Visual Analogue Scale score ranged from 0 to 8 with a mean score of 1.5 ±1.87. One patient complained of unbearable pain and had to be converted into general anesthesia (4.16%). Conclusion: Superficial Cervical Plexus Block with trigeminal mandibular local anesthesia has a high success rate, low complication rate, and high patient acceptance rate. However, caution should be exercised to ensure a low complication rate.


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