A Comparative Study of Oral Pregabalin versus Gabapentin on Hemodynamic Responses to Laryngoscopy and Endotracheal Intubation under General Anaestesia

Background and AimLaryngoscopy and endotracheal intubation are potent stimuli that can induce increased sympathetic activity leading to tachycardia, hypertension and dysrrhythmias. Various drugs and methods have been tried to obtund this response. To obtain ideal drugs, studies still continue.We compared the efficacy of pregabalin and gabapentin to attenuate the pressor response during laryngoscopy and intubation. Method: Total 120 patients of ASA grade I&II scheduled for elective surgery under general anaesthesia, were randomized into three groups. Group A received oral pregabalin 150mg 2 hrs prior to surgery, group B received oral gabapentin 800mg 2 hrs prior to surgery and group C received oral placebo 2 hrs prior to surgery. Heart rate and blood pressure (SBP, DBP &MAP) were recorded at baseline, before induction, before intubation, during laryngoscopy, 0, 1, 3, 5, and 10 minutes after intubation. Results: When compared to gabapentin and pregabalin, there was a significant increase in HR and MAP in control group after laryngoscopy and tracheal intubation. Pregabalin wasbetter than gabapentin in suppressing the pressor response. Conclusion: Pregabalin appears to be better than Gabapentin for control of haemodynamic response to laryngoscopy and intubation.Both drugs have anti-nociceptive effects that may be beneficial for controlling post-operative pain.

[1]  A. Talikoti,et al.  A Comparative Study of Oral Pregabalin and Clonidine for Attenuation of Hemodynamic Responses to Laryngoscopy and Tracheal Intubation , 2016 .

[2]  P. Gupta,et al.  Oral premedication with pregabalin or clonidine for hemodynamic stability during laryngoscopy and laparoscopic cholecystectomy: A comparative evaluation , 2011, Saudi journal of anaesthesia.

[3]  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.

[4]  A. Saliminia,et al.  Attenuation of hemodynamic responses following laryngoscopy and tracheal intubation -- comparative assessment of clonidine and gabapentin premedication. , 2009, Middle East journal of anaesthesiology.

[5]  M. Baykara,et al.  A comparison of esmolol and dexmedetomidine for attenuation of intraocular pressure and haemodynamic responses to laryngoscopy and tracheal intubation. , 2008, European journal of anaesthesiology.

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

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

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

[9]  D. Sessler,et al.  Preoperative Gabapentin Decreases Anxiety and Improves Early Functional Recovery from Knee Surgery , 2005, Anesthesia and analgesia.

[10]  R. K. Suri,et al.  The Effect of Magnesium Sulphate on Hemodynamics and Its Efficacy in Attenuating the Response to Endotracheal Intubation in Patients with Coronary Artery Disease , 1998, Anesthesia and analgesia.

[11]  B. Seifert,et al.  Effects of intravenous and oral clonidine on hemodynamic and plasma-catecholamine response due to endotracheal intubation. , 1997, Journal of clinical anesthesia.

[12]  N. Edwards,et al.  Myocardial ischaemia during tracheal intubation and extubation. , 1994, British journal of anaesthesia.

[13]  E. Bradley,et al.  Circulatory responses to laryngoscopy: the comparative effects of placebo, fentanyl and esmolol , 1989, Canadian journal of anaesthesia = Journal canadien d'anesthesie.

[14]  J. Reves,et al.  Cardiovascular Effects of Esmolol in Anesthetized Humans , 1985, Anesthesia and analgesia.

[15]  K. Messeter,et al.  Treatment of stress response to laryngoscopy and intubation with fentanyl , 1981, Anaesthesia.

[16]  R. Stoelting,et al.  Effect of Propranolol on Circulatory Responses to Induction of Diazepam‐Nitrous Oxide Anesthesia and to Endotracheal Intubation , 1981, Anesthesia and analgesia.

[17]  G. O'Sullivan,et al.  Droperidol and endotracheal intubation Attenuation of pressor response to laryngoscopy and intubation , 1980, Anaesthesia.

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

[19]  R. Stoelting.  Circulatory changes during direct laryngoscopy and tracheal intubation: influence of duration of laryngoscopy with or without prior lidocaine. , 1977, Anesthesiology.