Premedication with gabapentin for laryngoscopy: a double-blind randomized control trial in hypertensive patients

Abstract

Background & Objective: Laryngoscopy and intubation (L&I) are strong stimulus for cardiovascular system. Hypertensive patients have a greater incidence of coexisting coronary artery disease and cerebrovascular insufficiency. Several methods have been in practice to prevent or alter the hemodynamic response to L&I. Although the main use of gabapentin has been as an antiepileptic, but its effect on the hemodynamic reflexes is still under evaluation. We compared the effectiveness of a single dose of gabapentin 800 mg on the mean arterial pressure (MAP) in response to L&I in hypertensive patients undergoing day care surgery.
 Methodology: This randomized, control trial was conducted in operating rooms, Dr Ruth K M Pfau Civil Hospital Karachi, from May 2017 to November 2017. A total of 150 patients undergoing elective surgery requiring general anesthesia with tracheal intubation were included in this study. Patients were randomly allocated equally into two group; Group G (gabapentin group) and Group P (placebo group). Patients in Group G received gabapentin 800 mg and Group P received placebo, 2 h prior to induction of anesthesia. MAP was measured at baseline (before induction), before intubation (after induction), at time 0 (immediately after intubation), and at 1 min, 3 min, 5 min, and 10 min after intubation. Effectiveness was defined as all the MAP reading to be within 30% of the baseline reading.
 Results: There were 72(48%) males and 78(52%) females. Effectiveness was significantly higher in patients of Group G, as compared to placebo group (Group P) [94.7% vs. 65.3%; p = 0.0005].
 Conclusion: Gabapentin effectively suppresses the increase in MAP in response to laryngoscopy and tracheal intubation as compared to the placebo.
 Abbreviations: L&I: Laryngoscopy and intubation; MAP: Mean arterial pressure; ECG: Electrocardiography; ASA: American Society of Anesthesiologists; BMI: Body mass index; SBP: Systolic blood pressure; DBP: Diastolic blood pressure
 Key words: Laryngoscopy; Intubation; Hypertension; Gabapentin; Stress response
 Citation: Riasat MI, Chohan HT, Kumar A, Sultan SF, Javaid H, Siddiqui SZ. Premedication with gabapentin for laryngoscopy: a double-blind randomized control trial in hypertensive patients. Anaesth. pain intensive care 2021;25(2):163-169. DOI: 10.35975/apic.v25i2.1464