Perbandingan bupivacain 0,5% 15 mg dan fentanil 25 mcg dengna bupivacain 0,5% 15 mg terhadap nilai oksigenasi pada pasien dengan anestesi spinal

Author(s): Ahmad Ridho Lubis, Rr Sinta Irina, Rommy F. Nadeak, Yuki Yunanda
DOI: 10.30867/gikes.v5i1.1286


Background: Spinal anesthesia is a safe anesthetic technique for elective and emergency surgeries. Spinal anesthesia adversely affects cerebral oxygenation, especially when fentanyl is administered as an adjuvant to spinal anesthesia.

Objectives: To determine the difference in cerebral oxygenation values between patients undergoing spinal anesthesia using bupivacaine 0,5% with fentanyl and bupivacaine 0,5% in patients undergoing spinal anesthesia.

Methods: This was an analytic post-test experiment with a cross-sectional design. This study was conducted at the Haji Adam Malik Hospital Medan, with a total sample of 36 patients. The research group was divided into groups that received bupivacaine 0,5% 15 mg and bupivacaine 0,5% 15 mg plus fentanyl 25 µg. The rSO2 value was assessed before spinal action (T0), shortly after spinal anesthesia (T1), and 15 min after spinal anesthesia (T2). Near-infrared spectroscopy was used as the measurement instrument. Data to be collected were analyzed with a bivariate, independent T-test and Mann-Whitney test with a 95% confidence interval (CI).

Results: The average rSO2 values of patients who received bupivacaine were 64,0% on the right and 65,1% on the right and left sides, respectively. The average rSO2 values of patients who received bupivacaine were 74,8% on the right and 76,1% on the left. There was a significant difference in blood pressure and rSO2 values in patients who received 0,5% bupivacaine spinal anesthesia with 0,5% bupivacaine added to 25 µg fentanyl (p <0,05).

Conclusion: There was a significant difference in rSO2 values between patients who received 0,5% bupivacaine spinal anesthesia with 0,5% bupivacaine plus 25 µg fentanyl.



Bupivacaine, Fentanyl, rSO2, Spinal anesthesia

Full Text:



Bogra, J., Arora, N., & Srivastava, P. (2005). Synergistic effect of intrathecal fentanyl and bupivacaine in spinal anesthesia for cesarean section. BMC Anesthesiology, 5, 5.

Carlson, K. R., Driver, B. E., Satpathy, R., & Miner, J. R. (2021). Cerebral oximetry monitoring using near-infrared spectroscopy during adult procedural sedation: a preliminary study. Emergency Medicine Journal, emermed-2020-210802.

Denault, A., Deschamps, A., & Murkin, J. M. (2007). A proposed algorithm for the intraoperative use of cerebral near-infrared spectroscopy. Seminars in Cardiothoracic and Vascular Anesthesia, 11(4), 274–281.

Fonseca, N. M., Guimarães, G. M. N., Pontes, J. P. J., Azi, L. M. T. de A., & de Ávila Oliveira, R. (2023). Safety and effectiveness of adding fentanyl or sufentanil to spinal anesthesia: systematic review and meta-analysis of randomized controlled trials. Brazilian Journal of Anesthesiology (English Edition), 73(2), 198–216.

Habasha, Z. F. (2022). Synergistic effect of inthrathecal fentanyl and bupivacaine in spinal anesthesia for cesarean section in Baghdad city. International Journal Of Community Medicine And Public Health, 9(6), 2462–2465.

Kalliyath, A., Korula, S., Mathew, A., Abraham, S., & Isac, M. (2019). Effect of preoperative education about spinal anesthesia on anxiety and postoperative pain in parturients undergoing elective cesarean section: A randomized controlled trial.

Journal of Obstetric Anaesthesia and Critical Care, 9(1), 14.

Kim, D. J., Czosnyka, Z., Kasprowicz, M., Smieleweski, P., Baledent, O., Guerguerian, A. M., Pickard, J. D., & Czosnyka, M. (2012). Continuous Monitoring of the Monro-Kellie Doctrine: Is It Possible? Journal of Neurotrauma, 29(7), 1354.

Kusku, A., Demir, G., Cukurova, Z., Eren, G., & Hergunsel, O. (2014). Monitorization of the effects of spinal anaesthesia on cerebral oxygen saturation in elder patients using near-infrared spectroscopy. Brazilian Journal of Anesthesiology (English Edition), 64(4), 241–246.

Lange, F., & Tachtsidis, I. (2019). Clinical Brain Monitoring with Time Domain NIRS: A Review and Future Perspectives. Applied Sciences 2019, Vol. 9, Page 1612, 9(8), 1612.

Lee, J. K., Kibler, K. K., Benni, P. B., Easley, R. B., Czosnyka, M., Smielewski, P., Koehler, R. C., Shaffner, D. H., & Brady, K. M. (2009). Cerebrovascular reactivity measured by near-infrared spectroscopy. Stroke, 40(5), 1820–1826.

Mantyh, P. W., Clohisy, D. R., Koltzenburg, M., & Hunt, S. P. (2002). Molecular mechanisms of cancer pain. Nature Reviews Cancer, 2(3), 201–209.

Pascual, J. L., Georgoff, P., Maloney-Wilensky, E., Sims, C., Sarani, B., Stiefel, M. F., Leroux, P. D., & Schwab, C. W. (2011). Reduced brain tissue oxygen in traumatic brain injury: are most commonly used interventions successful? The Journal of Trauma, 70(3), 535–546.

Pellicer, A., & Bravo, M. del C. (2011). Near-infrared spectroscopy: A methodology-focused review. Seminars in Fetal and Neonatal Medicine, 16(1), 42–49.

Samraj, R. S., & Nicolas, L. (2015). Near infrared spectroscopy (NIRS) derived tissue oxygenation in critical illness. Clinical and Investigative Medicine. Medecine Clinique et Experimentale, 38(5), E285–E295.

Shukla, U., Malhotra, K., & Prabhakar, T. (2011). A comparative study of the effect of clonidine and tramadol on post-spinal anaesthesia shivering. Indian Journal of Anaesthesia, 55(3), 242.

Son, I. Y., & Yazici, B. (2006). Near infrared imaging and spectroscopy for brain activity monitoring. NATO Security through Science Series A: Chemistry and Biology, 341–372.

Vaskó, A., Siró, P., László, I., Szatmári, S., Molnár, L., Fülesdi, B., & Molnár, C. (2014). Assessment of cerebral tissue oxygen saturation in septic patients during acetazolamide provocation - a near infrared spectroscopy study. Acta Physiologica Hungarica, 101(1), 32–39.


  • There are currently no refbacks.