Perbandingan Perubahan Kadar Serum Kortisol pada Pasien yang Menjalani Kraniotomi Menggunakan Infus Kontinyu Lidokain dan Infus Kontinyu Fentanil

Abstract

Introduction Craniotomy is a surgical procedure on a portion of the skull, temporarily removing it to expose the brain and performing intracranial procedures. Surgery can be considered the standard model for assessing cortisol in the stress response. Cortisol in the blood can cause hemodynamic and physiological changes in the body such as increased heart rate, increased blood pressure, and also increased blood sugar levels. In the continuous infusion of fentanyl and lidocaine it is shown by some literature to have an effect in maintain the stress response, cortisol levels in the blood. Method This study used a double-blind randomized controlled trial (RCT) with a pretest posttest with control group design. This study was divided into 2 groups of continuous infusion of lidocaine and continuous infusion of fentanyl and then examined serum cortisol levels before and after in patients undergoing craniotomy. Results A total of 28 samples were obtained which included inclusion and exclusion criteria. In this study, 2 samples experienced massive bleeding, and 4 samples experienced increased heart rate, so that the number of samples included in the analysis was 22 samples. Pre and Postoperative mean difference cortisol levels for lidocaine and fentanyl were 193,90 and 153,90 with a P value of 0.021 Conclusion The study found an increase in serum cortisol levels in both the fentanyl and lidocaine groups. In the analysis results found significant difference between the two groups of fentanil and lidocaine.