Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-27T22:26:52.975Z Has data issue: false hasContentIssue false

Gabapentin reduces cardiovascular responses to laryngoscopy and tracheal intubation

Published online by Cambridge University Press:  04 April 2006

D. Memiş
Affiliation:
Trakya University, Department of Anaesthesiology and Reanimation, Edirne, Turkey
A. Turan
Affiliation:
Trakya University, Department of Anaesthesiology and Reanimation, Edirne, Turkey
B. Karamanlıoğlu
Affiliation:
Trakya University, Department of Anaesthesiology and Reanimation, Edirne, Turkey
Ş. Şeker
Affiliation:
Trakya University, Department of Anaesthesiology and Reanimation, Edirne, Turkey
M. Türe
Affiliation:
Trakya University, Department of Biostatistic, Edirne, Turkey
Get access

Extract

Summary

Background and objective: We have compared the effects of gabapentin on arterial pressure and heart rate at induction of anaesthesia and tracheal intubation in a randomized double-blind study. Methods: Ninety normotensive patients (ASA I) undergoing elective surgery were divided into three groups of 30 patients each. Patients received oral placebo (Group I), 400 mg of gabapentin (Group II) or 800 mg of gabapentin (Group III) 1 h prior to surgery in the operating theatre. After induction of anaesthesia heart rate and mean arterial pressure were recorded at baseline 1, 3, 5, 10 and 15 min after intubation. Results: Patients receiving placebo and 400 mg gabapentin showed a significant increase in blood pressure and heart rate associated with tracheal intubation compared to baseline levels and Group III. There was significant decrease in heart rate and arterial pressure in Group III after intubation 1, 3, 5 and 10 min (P < 0.001, P < 0.001, P < 0.05 and P < 0.05, respectively) compared to Groups I and II. Conclusion: Given 1 h before operation gabapentin 800 mg blunted the arterial pressure and heart rate increase in first 10 min due to endotracheal intubation. Oral administration of gabapentin 800 mg before induction of anaesthesia is a simple and practical method for attenuating pressor response to laryngoscopy and tracheal intubation after standard elective induction.

Type
Original Article
Copyright
© 2006 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Rosner H, Rubin L, Kestenbaum A. Gabapentin adjunctive therapy in neuropathic pain states. Clin J Pain 1996; 12: 5658.Google Scholar
Backonja M, Beydoun A, Edwards KR et al. Gabapentin for the symptomatic treatment of painful neuropathy in patients with diabetes mellitus: a randomized controlled trial. JAMA 1998; 280: 18311836.Google Scholar
Rowbotham M, Harden N, Stacey B et al. Gabapentin for the treatment of postherpetic neuralgia: a randomized controlled trial. JAMA 1998; 280: 18371842.Google Scholar
Mellick GA, Mellick LB. Reflex sympathetic dystrophy treated with gabapentin. Arch Phys Med Rehabil 1997; 78: 98105.Google Scholar
Mao J, Chen LL. Gabapentin in pain management. Anesth Analg 2000; 91: 680687.Google Scholar
Dirks J, Moiniche S, Hilsted KL, Dahl JB. Mechanisms of postoperative pain: clinical indications for a contribution of central neuronal sensitization. Anesthesiology 2002; 97: 15911596.Google Scholar
Shimoyama M, Shimoyama N, Inturrisi CE, Elliott KJ. Gabapentin enhances the antinociceptive effects of spinal morphine in the rat tail-flick test. Pain 1997; 72: 375382.Google Scholar
Eckhardt K, Ammon S, Hofman U et al. Gabapentin enhances the analgesic effect of morphine in healthy volunteers. Anesth Analg 2000; 91: 185191.Google Scholar
Caraceni A, Zecca E, Martini C, De Conno F. Gabapentin as an adjunctant to opioid analgesia for neuropathic cancer pain. J Pain Symptom Manage 1999; 17: 441445.Google Scholar
Turan A, Karamanlıoğlu B, Memiş D et al. Analgesic effect of gabapentin after spinal surgery. Anaesthesiology 2004; 100: 935938.Google Scholar
Turan A, Karamanlıoğlu B, Memiş D et al. The analgesic effects of gabapentin after total abdominal hysterectomy. Anesth Analg 2004; 98: 13701373.Google Scholar
Turan A, Memiş D, Karamanlıoğlu B et al. Analgesic effects of gabapentin in ear-nose-throat surgery. Anesth Analg 2004; 99: 375378.Google Scholar
Derbyshire DR, Smith G. Sympatoadrenal responses to anesthesia and surgery. Br J Anaesth 1984; 56: 725739.Google Scholar
Slogoff S, Keats AS. Does perioperative myocardial ischemia lead to postoperative myocardial infarction? Anesthesiology 1985; 62: 107114.Google Scholar
Cheong JK, Pan HL, Eisenach JC. Antiallodynic effect of intrathecal gabapentin and its interaction with clonidine in a rat model of postoperative pain. Anesthesiology 2000; 92: 11261131.Google Scholar
Field MJ, Holloman EF, McCleary S et al. Evaluation of gabapentin and S-(+)-3-isobutylgaba in a rat model of postoperative pain. J Pharmacol Exp Ther 1997; 282: 12421246.Google Scholar
Gee NS, Brown JP, Dissanayake VU et al. The novel anticonvulsant drug, gabapentin, binds to the alpha 2 delta subunit of a calcium channel. J Biol Chem 1996; 271: 57685776.Google Scholar
Luo ZD, Chaplan SR, Higuera ES et al. Upregulation of dorsal root ganglion (alpha) 2 (delta) calcium channel subunit and its correlation with allodynia in spinal nerve injured rats. J Neurosci 2001; 21: 18681875.Google Scholar
Maneuf Y, Mcknight A. Block by gabapentin of the facilitation of glutamate release from rat trigeminal nucleus following activation of protein kinase C or adenylyl cyclase. Br J Pharmacol 2001; 134: 237240.Google Scholar
Hurley RW, Chatterjea D, Feng RM, Taylor CP. Gabapentin and pregabalin can interact synergistically with naproxen to produce antihyperalgesia. Anesthesiology 2002; 97: 12631273.Google Scholar
Eckhardt K, Ammon S, Hofman U et al. Gabapentin enhances the analgesic effect of morphine in healthy volunteers. Anesth Analg 2000; 91: 185191.Google Scholar
Caraceni A, Zecca E, Martini C, De Conno F. Gabapentin as an adjunctant to opioid analgesia for neuropathic cancer pain. J Pain Symptom Manage 1999; 17: 441445.Google Scholar
Field MJ, Oles RJ, Lewis AS et al. Gabapentin (neurontin) and S-(+)-3-isobutylgaba represent a novel class of selective antihyperalgesic agents. Br J Pharmacol 1997; 121: 15131522.Google Scholar
van Hooft JA, Dougherty JJ, Endeman D et al. Gabapentin inhibits presynaptic Ca(2+) influx and synaptic transmission in rat hippocampus and neocortex. Eur J Pharmacol 2002; 449: 221228.Google Scholar
Beydoun A, Uthman BM, Sackellares JC. Gabapentin: pharmacokinetics, efficacy, and safety. Clin Neuropharmacol 1995; 18: 469481.Google Scholar
Mellegers MA, Furlan AD, Mailis A. Gabapentin for neuropathic pain: systematic review of controlled and uncontrolled literature. Clin J Pain 2001; 17: 284295.Google Scholar
Ramsay RE. Clinical efficacy and safety of gabapentin. Neurology 1994; 44: S23S30.Google Scholar
Rorarius MGF, Mennander S, Suominen P et al. Gabapentin for the prevention of postoperative pain after vaginal hysterectomy. Pain 2004; 110: 175181.Google Scholar
Pande AC, Pollack MH, Crockatt J et al. Placebo-controlled study of gabapentin treatment of panic disorder. J Clin Psychopharmacol 2000; 20: 467471.Google Scholar