Perbandingan Bupivakain 0,5% 15 MG dan Fentanil 25 MCG dengan Bupivakain 0,5% 15 MG pada Nilai Oksigenasi Serebral pada Pasien yang Menjalani Anestesi Spinal

Abstract

Introduction: Spinal anesthesia is an anesthetic technique used for elective and emergency surgery. Cerebral blood flow is defined as the difference between mean arterial and intracranial pressure, and is inversely proportional to cerebrovascular resistance. Non-invasive methods of monitoring tissue oxygenation can provide useful information about tissue oxygenation and microcirculation conditions. One technique for monitoring tissue oxygenation is near-infrared spectroscopy (NIRS). Previous studies have shown that spinal anesthesia adversely affects cerebral oxygenation, especially in the administration of fentanyl in addition to spinal anesthesia. Nonetheless, offering fentanyl as adjuvants has many clinical benefits. Method: This research is an analytic post test experimental study, with cross sectional method with the aim to compare the value of brain oxygen saturation. Obtained a total sample of 36 patients. And divided into 2 groups, the group that received bupivacaine 0.5% 15 mg and bupivacaine 0.5% 15 mg plus fentanyl 25 mcg. rSO2 .valueassessed before spinal (T0), immediately after spinal (T1), and 15 minutes after spinal anesthesia (T2). Results: The average rSO2 value of patients receiving bupivacaine plus fentanyl was 64.0 on the right side and 65.1 on the left. The average rSO2 value of patients receiving bupivacaine was 74.8 on the right side and 76.1 on the left side and there was a significant difference in the values rSO2 in patients receiving spinal anesthesia with 0.5% bupivacaine with 0.5% bupivacaine plus 25 mcg of fentanyl. Discussion: The value of rSO2 in this study was found to be a decrease in rSO2 at T1 in both groups then at T2 in the group without fentanyl, the rSO2 value began to increase and increased again at T3, in patients who received spinal anesthesia with bupivacaine plus fentanyl there was a decrease in rSO2 values at T2 and T3, this is due to the effect of intrathecal fentanyl which can reduce MAP and CPP resulting in a decrease in rSO2.