Peran blok servikal superfisialis pada timpanomastoidektomi dalam anestesia umum

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.