Scalp block is a regional anesthesia technique that can be combined with neuroanesthesia for Craniotomy Tumor Resection (CTR) procedures. Its advantages include attenuation of the stress response during surgery, maintenance of hemodynamic stability, and reduction in intraoperative opioid requirements. This study was a double-blinded randomized controlled trial involving 28 patients aged 18–65 years with a Glasgow Coma Scale (GCS) score of 15 and an American Society of Anesthesiologists (ASA) physical status of II–III. All subjects were diagnosed with intracranial tumors and underwent CTR at Mohammad Hoesin Hospital, Palembang. Participants were randomly assigned to one of two treatment groups receiving general anesthesia combined with a scalp block using either 0.125% or 0.25% bupivacaine. Exclusion criteria included allergy to bupivacaine, hemorrhagic shock, and surgery lasting more than six hours. Hemodynamic variables measured were systolic blood pressure (SBP), Diastolic Blood Pressure (DBP), Mean Arterial Pressure (MAP), and Heart Rate (HR). Data were analyzed using a general linear model—repeated-measures ANOVA, paired t-tests, and independent t-tests—with SPSS. No significant difference was found between the two groups in terms of changes in SBP, DBP, MAP, or HR over time (independent t-test, p > 0.05). However, significant hemodynamic changes were observed over time within each group (repeated-measures ANOVA and paired t-test, p < 0.05).

No adverse effects were reported in either group. Additionally, there was no significant difference in intraoperative fentanyl requirements between the two groups (p > 0.05). Scalp block using 0.125% bupivacaine is as effective as 0.25% bupivacaine in maintaining hemodynamic stability during tumor resection craniotomy surgery. The use of a scalp block reduces intraoperative opioid requirements without increasing the risk of adverse effects.

Afprimadhona R Adiwarman has completed as Anesthesiologist 2024 from Sriwijaya University, Palembang, Indonesia. He have been serving as an Anesthesiologist at Siti Khadijah Islamic Hospital, Palembang.