Effects of preoperative oral gabapentin in reduction of intraocular pressure and cardiovascular changes following laryngoscopy and tracheal intubation

Laryngoscopy and tracheal intubation are associated with hypertension, tachycardia and increased circulating catecholamines. They are also associated with increase in intraocular pressure. Various techniques have been studied to prevent increase intraocular pressure. Also there were used various techniques for attenuate the hemodynamic response to laryngoscopy and intubation. Gabapentin is a multimodal perioperative drug. We investigated whether the pre-treatment with gabapentin attenuates the intraocular pressure in addition to a hemodynamic response to tracheal intubation. Methods: One hundred patients, 15-50 years of age with ASA class I, II undergoing elective surgery with general anesthesia and endotracheal intubation were divided in two groups. Fifty patients received placebo and fifty patients received 900 mg (capsule) gabapentin two hours before surgery. Results: Intraocular pressure and heart rate in 1, 3, 5 and 10 minutes after laryngoscopy and intra-tracheal intubation in the gabapentin group were significantly lower than placebo group. In addition in our study mean arterial pressure in 1, 3, 5 minutes after laryngoscopy and tracheal intubation in the gabapentin group were significantly lower than placebo group. Conclusion: preoperative premedication with oral gabapentin is effective in attenuating the hemodynamic response and prevention of increase IOP to laryngoscopy and endotracheal intubation.

[1]  H. Haybar,et al.  Gabapentin May Relieve Post-Coronary Artery Bypass Graft Pain: A Double Blind Randomized Clinical Trial , 2011 .

[2]  A. Garg,et al.  A Comparison of Different Doses of Gabapentin to Attenuate the Haemodynamic Response to Laryngoscopy and Tracheal Intubation in Normotensive Patients , 2011, Journal of anaesthesiology, clinical pharmacology.

[3]  D. Memis,et al.  The Preoperative Use of Gabapentin, Dexamethasone, and Their Combination in Varicocele Surgery: A Randomized Controlled Trial , 2007, Anesthesia and analgesia.

[4]  M. Türe,et al.  Gabapentin reduces cardiovascular responses to laryngoscopy and tracheal intubation , 2006, European journal of anaesthesiology.

[5]  A. Paraskeva,et al.  Gabapentin attenuates the pressor response to direct laryngoscopy and tracheal intubation. , 2006, British journal of anaesthesia.

[6]  J. Dahl,et al.  Mechanisms of Postoperative Pain: Clinical Indications for a Contribution of Central Neuronal Sensitization , 2002, Anesthesiology.

[7]  Y. Adachi,et al.  Fentanyl Attenuates the Hemodynamic Response to Endotracheal Intubation More Than the Response to Laryngoscopy , 2002, Anesthesia and analgesia.

[8]  Q. Hogan,et al.  Gabapentin Decreases Membrane Calcium Currents in Injured as Well as in Control Mammalian Primary Afferent Neurons , 2001, Regional Anesthesia & Pain Medicine.

[9]  A. Beydoun,et al.  Gabapentin for the Symptomatic Treatment of Painful Neuropathy in Patients With Diabetes Mellitus: a Randomized Controlled Trial , 1999 .

[10]  G. Holmes,et al.  Safety and Tolerability of Gabapentin as Adjunctive Therapy in a Large, Multicenter Study , 1999, Epilepsia.

[11]  J. Russell,et al.  Effect of remifentanil on the haemodynamic response to orotracheal intubation. , 1998, British journal of anaesthesia.

[12]  L. Mellick,et al.  Reflex sympathetic dystrophy treated with gabapentin. , 1997, Archives of physical medicine and rehabilitation.

[13]  J. Offord,et al.  The Novel Anticonvulsant Drug, Gabapentin (Neurontin), Binds to the Subunit of a Calcium Channel (*) , 1996, The Journal of Biological Chemistry.

[14]  A. Kovac.  Controlling the hemodynamic response to laryngoscopy and endotracheal intubation. , 1996, Journal of clinical anesthesia.

[15]  F. Ellis,et al.  Esmolol hydrochloride for management of the cardiovascular stress responses to laryngoscopy and tracheal intubation. , 1992, British journal of anaesthesia.

[16]  R. Robinson,et al.  Effect of anaesthesia on intraocular blood flow. , 1991, The British journal of ophthalmology.

[17]  N. Maekawa,et al.  The effect of diltiazem on the cardiovascular response to tracheal intubation , 1990, Anaesthesia.

[18]  S. Mostafa,et al.  Effects of nebulized lignocaine on the intraocular pressure responses to tracheal intubation. , 1990, British journal of anaesthesia.

[19]  G. Smith,et al.  Cardiovascular and catecholamine responses to laryngoscopy with and without tracheal intubation. , 1987, British journal of anaesthesia.

[20]  D. Murphy.  Anesthesia and Intraocular Pressure , 1985, Anesthesia and analgesia.

[21]  A. Fassoulaki,et al.  Intranasal administration of nitroglycerine attenuates the pressor response to laryngoscopy and intubation of the trachea. , 1983, British journal of anaesthesia.

[22]  A. Fassoulaki,et al.  Does atropine premedication affect the cardiovascular response to laryngoscopy and intubation? , 1982, British journal of anaesthesia.

[23]  W. J. Russell,et al.  Changes in plasma catecholamine concentrations during endotracheal intubation. , 1982, British journal of anaesthesia.

[24]  B. Gilbert,et al.  Myocardial ischemia during non-cardiac surgical procedures in patients with coronary-artery disease. , 1979 .

[25]  E. Fox,et al.  Complications related to the pressor response to endotracheal intubation. , 1977, Anesthesiology.

[26]  D. Bruce,et al.  Thiopental and Succinylcholine: Action on Intraocular Pressure , 1975, Anesthesia and analgesia.

[27]  F. Foldes,et al.  Effect of Anesthetic Drugs and Muscle Relaxants on Intraocular Pressure , 1973, International ophthalmology clinics.

[28]  J. D. Elder,et al.  REFLEX CIRCULATORY RESPONSES TO DIRECT LARYNGOSCOPY AND TRACHEAL INTUBATION PERFORMED DURING GENERAL ANESTHESIA , 1951, Anesthesiology.