PENGARUH BLOK PARAVERTEBRA INJEKSI MULTIPEL TERHADAP KADAR KORTISOL PLASMA PASIEN OPERASI TUMOR PAYUDARA

Abstract

Background: Bilateral thoracal paravertebral block, eventhough it is rare, also have been done perioperatively in thoracal and breast surgery. One of the paravertebral block methods is with multiple injection technique. Systemic responses after surgery consisted of generally increased catabolic hormones such as cathecolamine, cortisol, renin, aldosteron, and glucagon which can increase hyperglicemia, muscle protein metabolism and lypolisis. Cortisol has an important element which is involved in stress response, psychological trauma, and inflammation response. Objective: To prove the effect of multiple injections paravertebral block towards pre and post operative plasma cortisol level in patients who underwent breast tumor surgery. Methods: The design of this study is an observational study using cross sectional design in 10 patients who underwent breast tumor surgery with multiple injection paravertebral block and fulfilled the incllusion and exclusion criteria. After that the preoperative and postoperative plasma cortisol level was being assessed. Statistical test using pair t test. Results: There was a change in pre operative and post operative plasma cortisol level. The average of preoperative plasma cortisol level was 256,55 μg/dl while postoperative plasma cortisol level decreased into 224,73 μg/dl. In the other hand, matching to the statistic test, the difference between cortisol plasma before and after surgery was insignificant (p=0.061). Conclusion: There was a decrease in pre and post operative plasma cortisol level in patients with multiple injections paravertebral block. But according to statistic result, there was no significant difference. Keywords : multiple injection paravertebral block , plasma cortisol level