Comparison of Changes in Cortisol Values Before and After Administration of a Combination of Continuous Fentanyl and Paracetamol Drip in Post-Craniotomy Patients in ICU of Haji Adam Malik General Hospital Medan

Introduction: Post-craniotomy surgical pain can trigger an inflammatory response and release various stress response mediators. Prolonged stress response to pain can increase cortisol secretion which will eventually be resulted in cortisol dysfunction and widespread inflammation. Opioids have been s...

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Main Authors: Cassandra Etania, Rr Sinta Irina, Muhammad Ihsan
Format: Article
Language:Indonesian
Published: Indonesian Society of Neuroanesthesia & Critical Care (INA-SNACC) 2025-10-01
Series:Jurnal Neuroanestesi Indonesia
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Online Access:https://inasnacc.org/ojs2/index.php/jni/article/view/593
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author Cassandra Etania
Rr Sinta Irina
Muhammad Ihsan
author_facet Cassandra Etania
Rr Sinta Irina
Muhammad Ihsan
author_sort Cassandra Etania
collection DOAJ
description Introduction: Post-craniotomy surgical pain can trigger an inflammatory response and release various stress response mediators. Prolonged stress response to pain can increase cortisol secretion which will eventually be resulted in cortisol dysfunction and widespread inflammation. Opioids have been shown to provide pain management after craniotomy. Fentanyl is a commonly used opioid analgesic to manage postoperative pain. The addition of paracetamol is often used as multimodal analgesia which aims to reduce postoperative pain and to minimize the stress response that occurs. The aim of the study was to obtain a comparison of changes in cortisol values before and after the administration of a combination of continuous fentanyl and paracetamol in post-craniotomy patients in the ICU of Haji Adam Malik General Hospital Medan. Subject and Methods: This research design used a cross sectional test with pretest and posttest design, with primary data sources obtained directly from examinations on patients in the ICU. This study involved 15 post-craniotomy patients in the ICU with mechanical ventilation. The cortisol levels in the patient’s blood were checked before and after administration continuous fentanyl and paracetamol drip. Results: There was a decrease in cortisol levels after being given a combination of continuous fentanyl and paracetamol drip in post-craniotomy patients by 18% with a p-value of 0.001 (p <0.05). Conclusion: Combination of continuous fentanyl and paracetamol drip can provide analgesia effects that can reduce the stress response, namely cortisol.
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spelling doaj-art-dee6f62fa699476e89a4356ef8d387be2025-08-20T01:47:37ZindIndonesian Society of Neuroanesthesia & Critical Care (INA-SNACC)Jurnal Neuroanestesi Indonesia2088-96742460-23022025-10-01133115121https://doi.org/10.24244/jni.v13i3.593Comparison of Changes in Cortisol Values Before and After Administration of a Combination of Continuous Fentanyl and Paracetamol Drip in Post-Craniotomy Patients in ICU of Haji Adam Malik General Hospital MedanCassandra Etania0Rr Sinta Irina1 Muhammad Ihsan2Resident of Clinical Medicine Study Program, Department of Anesthesiology and Intensive Therapy of Universitas Sumatera Utara, MedanDepartment of Anesthesiology and Intensive Therapy, Faculty of Medicine, Universitas Sumatra Utara, MedanDepartment of Anesthesiology and Intensive Therapy, Faculty of Medicine, Universitas Sumatra Utara, MedanIntroduction: Post-craniotomy surgical pain can trigger an inflammatory response and release various stress response mediators. Prolonged stress response to pain can increase cortisol secretion which will eventually be resulted in cortisol dysfunction and widespread inflammation. Opioids have been shown to provide pain management after craniotomy. Fentanyl is a commonly used opioid analgesic to manage postoperative pain. The addition of paracetamol is often used as multimodal analgesia which aims to reduce postoperative pain and to minimize the stress response that occurs. The aim of the study was to obtain a comparison of changes in cortisol values before and after the administration of a combination of continuous fentanyl and paracetamol in post-craniotomy patients in the ICU of Haji Adam Malik General Hospital Medan. Subject and Methods: This research design used a cross sectional test with pretest and posttest design, with primary data sources obtained directly from examinations on patients in the ICU. This study involved 15 post-craniotomy patients in the ICU with mechanical ventilation. The cortisol levels in the patient’s blood were checked before and after administration continuous fentanyl and paracetamol drip. Results: There was a decrease in cortisol levels after being given a combination of continuous fentanyl and paracetamol drip in post-craniotomy patients by 18% with a p-value of 0.001 (p <0.05). Conclusion: Combination of continuous fentanyl and paracetamol drip can provide analgesia effects that can reduce the stress response, namely cortisol.https://inasnacc.org/ojs2/index.php/jni/article/view/593craniotomyicufentanylparacetamolcortisol
spellingShingle Cassandra Etania
Rr Sinta Irina
Muhammad Ihsan
Comparison of Changes in Cortisol Values Before and After Administration of a Combination of Continuous Fentanyl and Paracetamol Drip in Post-Craniotomy Patients in ICU of Haji Adam Malik General Hospital Medan
Jurnal Neuroanestesi Indonesia
craniotomy
icu
fentanyl
paracetamol
cortisol
title Comparison of Changes in Cortisol Values Before and After Administration of a Combination of Continuous Fentanyl and Paracetamol Drip in Post-Craniotomy Patients in ICU of Haji Adam Malik General Hospital Medan
title_full Comparison of Changes in Cortisol Values Before and After Administration of a Combination of Continuous Fentanyl and Paracetamol Drip in Post-Craniotomy Patients in ICU of Haji Adam Malik General Hospital Medan
title_fullStr Comparison of Changes in Cortisol Values Before and After Administration of a Combination of Continuous Fentanyl and Paracetamol Drip in Post-Craniotomy Patients in ICU of Haji Adam Malik General Hospital Medan
title_full_unstemmed Comparison of Changes in Cortisol Values Before and After Administration of a Combination of Continuous Fentanyl and Paracetamol Drip in Post-Craniotomy Patients in ICU of Haji Adam Malik General Hospital Medan
title_short Comparison of Changes in Cortisol Values Before and After Administration of a Combination of Continuous Fentanyl and Paracetamol Drip in Post-Craniotomy Patients in ICU of Haji Adam Malik General Hospital Medan
title_sort comparison of changes in cortisol values before and after administration of a combination of continuous fentanyl and paracetamol drip in post craniotomy patients in icu of haji adam malik general hospital medan
topic craniotomy
icu
fentanyl
paracetamol
cortisol
url https://inasnacc.org/ojs2/index.php/jni/article/view/593
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