Comparison of the Values of Inflammatory Parameters C-Reactive Protein, Neutrophil Lymphocyte Ratio, Platelet Lymphocyte Ratio between Scalp Block Ropivacaine 0.5% and Intravenous Dexmedetomidine in Craniotomy Brain Tumors

Muhamad Soleh, Rr Sinta Irina, Ester L.R. Silaen Silaen, Arlinda Sari Wahyuni

Abstract


Background and Objective: Craniotomy surgery can increase the body's inflammatory response through the neuroendocrine system. neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and C-reactive protein (CRP) are biomarkers of inflammation and immunosuppression. Scalp block using ropivacaine and intravenous dexmedetomidine are commonly used analgesic techniques to attenuate perioperative inflammatory responses. This study aims to determine the comparison of inflammatory marker values between ropivacaine 0.5% scalp block and intravenous dexmedetomidine in brain tumor craniotomy

Subject and Methods: This study used a single-blind clinical trial with a two-group posttest-only design. This study collected 36 research subjects who met the inclusion criteria. The subjects were divided into 2 groups, Group A received 0.5% ropivacaine scalp block and Group B received intravenous. Blood tests to assess inflammatory: markers were performed before and 24 hours postoperatively. The data obtained were analysed using SPSS version 20.

Results: The change value of CRP in the scalp block ropivacaine 0.5% group was 24.71± 7.25 mg/l, while the change value of CRP in the dexmedetomidine group was 61.02 ± 17.81mg /l. The change value of PLR in the scalp block ropivacaine 0.5% group was 50.57 ± 57.91 while the change value of PLR in the dexmedetomidine group was 105.26 ± 64.81. There was a significant change of CRP and PLR values in the scalp block group compared to the dexmedetomidine group (p<0.05). The change value of NLR in the scalp block group was 9.71 ± 5.75, while the change value of NLR in the demedetomidine group was 13.37 ± 5.55. There was no significant difference in the change value of NLR in the ropivacaine 0.5% scalp block group compared to dexmedetomidine (p>0.05).

Conclusion: Scalp block ropivacaine 0.5% has better results than intravenous dexmedetomidine administration in suppressing the inflammatory response in patients undergoing tumour craniotomy surgery.


Keywords


NLR, PLR, CRP, scalp block, ropivacaine, dexmedetomidine, craniotomy

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References


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DOI: https://doi.org/10.24244/jni.v15i2.645

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