KUMJ | VOL. 9 | NO. 4 | ISSUE 36 | OCT-DEC, 2011

Use of Gabapentin, Esmolol or Their Combination to Attenuate Haemodynamic Response to Laryngoscopy and Intubation
Shrestha GS, Marhatta MN, Amatya R

Background

Laryngoscopy and intubation increases blood pressure and heart rate.

Objective

The study aims to investigate the effect and safety of gabapentin, esmolol or their

combination on the haemodynamic response to laryngoscopy and intubation.

Methods

A total of 72 patients undergoing elective surgery were randomly allocated to one

of the four groups. First study drug was administered orally as gabapentin 1200mg

or placebo. Second study drug was administered intravenously as esmolol 1.5mg/

kg or normal saline. Heart rate, rate pressure product, systolic blood pressure and

mean arterial pressure were recorded at baseline and at zero, one, three and five

minutes after tracheal intubation.

Results

Baseline values were compared with the values at various time intervals within the

same group. In group PE (placebo, esmolol), there was significant decrease in heart

rate and rate pressure product at five minutes. In group GN (gabapentin, normal

saline), there was significant decrease in systolic blood pressure and mean arterial

pressure at five minutes. In group GE (gabapentin, esmolol), there was significant

decrease in heart rate at zero, three and five minutes. Systolic blood pressure, mean

arterial pressure and rate pressure product was significantly lower at three and

five minutes. In group PN (placebo, normal saline), there was significant increase

in heart rate at zero, one, three and five minutes; systolic blood pressure at zero

and one minutes; mean arterial pressure at zero and one minutes & rate pressure

product at zero, one and three minutes. In group GN (gabapentin, normal saline),

there was significant increase in heart rate at zero, one and three minutes & rate

pressure product at zero, one and three minutes. In group PE (placebo, esmolol),

there was significant increase in systolic blood pressure at zero and one minutes &

mean arterial pressure at zero and one minutes. However, in group GE (gabapentin,

esmolol) none of the variables showed statistically significant increase at any time.

Inter-group comparison was made for each time point. At zero minute, there was

significant difference in heart rate between groups PN and GE, GN and PE & GN and

GE Significant difference was also noted in rate pressure product between PN and

GE at zero minute. At one minute there was difference in heart rate between PN

and PE, PN and GE, GN and PE & between GN and GE. Significant difference was

observed in rate pressure product between PN and PE & between PN and GE at one

minute. No significant side effects of the study drugs were observed.

Conclusions

Combination of gabapentin and esmolol in this study design is safe and better

attenuates both the pressor and tachycardic response to laryngoscopy and

intubation, than either agent alone.