Abstrak 
Scalp Nerve Block pada Kraniotomi Evakuasi Pasien Moderate Head Injury dengan Subdural Hemorrhage dan Intracerebral Hemorrhag Frontotemporoparietal Dekstra Mencegah Stress Response Selama dan Pascabedah
Mariko Gunadi, Suwarman
Universitas Padjadjaran, Jurnal Anestesi Perioperatif[JAP. 2013;1(3):197–204]
Indonesia
Universitas Padjadjaran, Jurnal Anestesi Perioperatif[JAP. 2013;1(3):197–204]
Insisi kulit dan kraniotomi selama operasi intrakranial merupakan stimulus berbahaya yang dapat menghasilkan stress response yang menyebabkan peningkatan tekanan intrakranial. Scalp nerve block efektif dalam mengurangi stress response ini, selain itu juga dapat digunakan sebagai analgetik pascabedah. Seorang laki-laki usia 22 tahun dengan moderate head injury, subdural hemorrhage, dan intracerebral hemorrhage at regio fronto-temporo-parietal dextra dilakukan kraniotomi evakuasi dalam combined scalp nerve block – general anesthesia di Rumah Sakit Dr. Hasan Sadikin Bandung pada tanggal 14 Agustus 2012. Setelah dilakukan induksi dan sebelum insisi dilakukan scalp nerve block dengan bupivakain 0,5%. Hemodinamik (tekanan darah dan denyut jantung) setelah insisi kulit dan kraniotomi, serta glukosa darah pascabedah tidak menunjukkan perubahan yang signifikan. Analgetik pascabedah baru diberikan setelah 8 jam sejak dilakukan blok. Hasil ini menunjukkan scalp nerve block menggunakan bupivakain 0,5% mampu menumpulkan stress response dan dapat digunakan sebagai analgetik pascabedah.
Skin incision and craniotomy are recognized as an acute noxious stimulation during intracranial surgery which may result in stress response causing an increase in intracranial pressure. Scalp nerve block may be effective in reducing stress response. It can also be used to provide post operative analgesia. A twenty two years old male with moderate head injury, subdural hemorrhage, intracerebral hemorrhage at right frontotemporo-parietal region underwent evacuation craniotomy with combined scalp nerve block and general anesthesia at Dr. Hasan Sadikin Hospital Bandung on August 14th 2012. After induction and before incision of the skin, a scalp nerve block was performed using 0.5% bupivacaine. Hemodynamic (blood pressure and heart rate) changes after incision of the skin and craniotomy were not significant, and so was postoperative blood glucose concentration. Post operative analgetic was given eight hours after the block. The result demonstrates that scalp nerve block using 0.5% bupivacaine successfully blunts stress response and can be used as post operative analgesia.