To Study Effect of Gabapentin on Attenuation of Pressor Response to Direct Laryngoscopy and Tracheal Intubation and on Perioperative Pain

Abstract

Introduction: Endotracheal intubation has become an integral part of anaesthetic management and critical care since its description in 1921 by Rowbotham and Magill. In 1940 Reid and Brace first described haemodynamic response to laryngoscopy and intubation due to noxious stimuli. Evidence from laboratory data demonstrates that epipharyngeal and laryngopharyngeal stimulation augments cervical sympathetic activity in efferent fibres of the heart. Materials and Methods: A clinical comparative study of attenuation of sympathetic response to laryngoscopy and intubation was done in 150 patients posted for elective surgery. Study was conducted in Gandhi Hospital, Secunderabad after obtaining approval of the hospital ethical committee and written informed consent from the patients. General anaesthesia was provided with endotracheal intubation in all patients. Patients undergoing Elective surgeries where Intubation is required. Following criteria’s were adopted for selecting patients. Results: The age distribution in years in control and the two study groups. The age range was 20-50 years for control and study groups. The mean values of age with standard deviation are 29.27±6.883 and 28.78±8.517 in control and Gabapentin group respectively. There was no significant difference between two groups (p value>0.05). Conclusion: Based on the present clinical comparative study the following conclusions can be made: In patients with no drugs to attenuate the sympathetic response to laryngoscopy and intubation the maximum raise in heart rate, systolic, diastolic and mean arterial blood pressures were statistically and clinically very highly significant and can be detrimental in high risk patients. Gabapentin significantly attenuates the sympathetic response to laryngoscopy and tracheal intubation.