EFFECTIVENESS OF SUPRAZYGOMATIC MAXILLARY BLOCK SUPPLEMENTATION IN GENERAL ANESTHESIA  FOR MIDFACIAL SURGERY

Hengky Hengky; Pontisomaya Parami; I Gusti Ngurah Mahaalit Aribawa; I Made Gede Widnyana; Tjokorda Gde Agung Senapathi

doi:10.31004/prepotif.v9i3.42890

Authors

Hengky Hengky Anesthesiology and Intensive Care Department, Prof. Dr. dr. IGNG Ngoerah General Hospital, Denpasar, Bali, Indonesia
Pontisomaya Parami Anesthesiology and Intensive Care Department, Udayana University General Hospital, Denpasar, Bali, Indonesia
I Gusti Ngurah Mahaalit Aribawa Anesthesiology and Intensive Care Department, Udayana University General Hospital, Denpasar, Bali, Indonesia
I Made Gede Widnyana Anesthesiology and Intensive Care Department, Udayana University General Hospital, Denpasar, Bali, Indonesia
Tjokorda Gde Agung Senapathi Anesthesiology and Intensive Care Department, Udayana University General Hospital, Denpasar, Bali, Indonesia

DOI:

https://doi.org/10.31004/prepotif.v9i3.42890

Keywords:

general anesthesia, opioids, midfacial surgery, maxillary block, quality of recovery

Abstract

Operasi midfasial sering menimbulkan nyeri hebat yang dapat mempengaruhi durasi perawatan pascaoperasi. Opioid tetap menjadi standar utama dalam mengelola nyeri akut pascaoperasi, namun penggunaannya terkait dengan efek samping seperti mual, muntah, sedasi, dan risiko komplikasi pernapasan. Oleh karena itu, blok saraf regional seperti Suprazygomatic Maxillary Block (SMB) menawarkan alternatif untuk mengurangi dosis opioid dan efek sampingnya, mendukung konsep Enhanced Recovery After Surgery (ERAS). Penelitian ini merupakan uji coba terkontrol secara acak, single-blind, dan dilakukan di satu lokasi dengan 40 sampel yang dibagi menjadi dua kelompok: Kelompok P1 (anestesi umum dengan SMB menggunakan 5 ml ropivakain 0,375%) dan Kelompok P2 (anestesi umum tanpa SMB). Parameter yang dianalisis meliputi kebutuhan fentanyl intraoperatif, waktu pemberian analgesik penyelamat pertama, total kebutuhan opioid dalam 24 jam, kejadian mual dan muntah, serta kualitas pemulihan pascaoperasi (QoR-40), menggunakan SPSS versi 26. Hasil penelitian menunjukkan bahwa kebutuhan fentanyl intraoperatif lebih rendah pada Kelompok P1 (2,10 mcg/kgBB vs. 2,61 mcg/kgBB, p<0,001). Waktu pemberian analgesik penyelamat pertama lebih lama pada Kelompok P1 (13 jam vs. 2 jam, p=0,004), dan total kebutuhan opioid dalam 24 jam lebih rendah (0 mcg vs. 180 mcg, p<0,001). Kelompok P2 memiliki risiko mual dan muntah yang lebih tinggi (RR 2,54, p=0,004) dan skor QoR-40 pascaoperasi yang lebih rendah (198 vs. 162, p<0,001). Kesimpulannya, suplementasi SMB secara efektif mengurangi kebutuhan opioid intra dan pascaoperasi, menunda waktu pemberian analgesik penyelamat pertama, serta menurunkan risiko mual dan muntah pascaoperasi.

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