Gabapentin reduces cardiovascular responses to laryngoscopy and tracheal intubation

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.

[1]  A. Turan,et al.  The Analgesic Effects of Gabapentin in Monitored Anesthesia Care for Ear-Nose-Throat Surgery , 2004, Anesthesia and analgesia.

[2]  A. Yli-Hankala,et al.  Gabapentin for the prevention of postoperative pain after vaginal hysterectomy , 2004, Pain.

[3]  M. Türe,et al.  The Analgesic Effects of Gabapentin After Total Abdominal Hysterectomy , 2004, Anesthesia and analgesia.

[4]  D. Memis,et al.  Analgesic Effects of Gabapentin after Spinal Surgery , 2004, Anesthesiology.

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

[6]  R. Hurley,et al.  Gabapentin and Pregabalin Can Interact Synergistically with Naproxen to Produce Antihyperalgesia , 2002, Anesthesiology.

[7]  J. J. Dougherty,et al.  Gabapentin inhibits presynaptic Ca(2+) influx and synaptic transmission in rat hippocampus and neocortex. , 2002, European journal of pharmacology.

[8]  A. Furlan,et al.  Gabapentin for Neuropathic Pain: Systematic Review of Controlled and Uncontrolled Literature , 2001, The Clinical journal of pain.

[9]  A. McKnight,et al.  Block by gabapentin of the facilitation of glutamate release from rat trigeminal nucleus following activation of protein kinase C or adenylyl cyclase , 2001, British journal of pharmacology.

[10]  L. Sorkin,et al.  Upregulation of Dorsal Root Ganglion α2δ Calcium Channel Subunit and Its Correlation with Allodynia in Spinal Nerve-Injured Rats , 2001, The Journal of Neuroscience.

[11]  M. Pollack,et al.  Placebo-controlled study of gabapentin treatment of panic disorder. , 2000, Journal of clinical psychopharmacology.

[12]  U. Hofmann,et al.  Gabapentin Enhances the Analgesic Effect of Morphine in Healthy Volunteers , 2000, Anesthesia and analgesia.

[13]  J. Eisenach,et al.  Antiallodynic Effect of Intrathecal Gabapentin and Its Interaction with Clonidine in a Rat Model of Postoperative Pain , 2000, Anesthesiology.

[14]  J. Mao,et al.  Gabapentin in pain management. , 2000, Anesthesia and analgesia.

[15]  E. Zecca,et al.  Gabapentin as an adjuvant to opioid analgesia for neuropathic cancer pain. , 1999, Journal of pain and symptom management.

[16]  M. Rowbotham,et al.  Gabapentin for the treatment of postherpetic neuralgia: a randomized controlled trial. , 1998, JAMA.

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

[18]  K. Elliott,et al.  Gabapentin enhances the antinociceptive effects of spinal morphine in the rat tail-flick test , 1997, Pain.

[19]  S. McCleary,et al.  Evaluation of gabapentin and S-(+)-3-isobutylgaba in a rat model of postoperative pain. , 1997, The Journal of pharmacology and experimental therapeutics.

[20]  S. McCleary,et al.  Gabapentin (neurontin) and S‐(+)‐3‐isobutylgaba represent a novel class of selective antihyperalgesic agents , 1997, British journal of pharmacology.

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

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

[23]  H. Rosner,et al.  Gabapentin adjunctive therapy in neuropathic pain states. , 1996, The Clinical journal of pain.

[24]  J. Sackellares,et al.  Gabapentin: Pharmacokinetics, Efficacy, and Safety , 1995, Clinical neuropharmacology.

[25]  R. Ramsay.  Clinical efficacy and safety of gabapentin , 1994, Neurology.

[26]  D. Newman,et al.  Brainstem reticular nuclei that project to the thalamus in rats: a retrograde tracer study , 1992 .

[27]  A. Keats,et al.  Does Perioperative Myocardial Ischemia Lead to Postoperative Myocardial Infarction? , 1985, Anesthesiology.

[28]  G. Smith,et al.  Sympathoadrenal responses to anaesthesia and surgery. , 1984, British journal of anaesthesia.