Title: Comparison of Gabapentin and Labetalol in Attenuating the Stress Response to Laryngoscopy and Intubation

Authors: Shahnawaz Khaliq, Tantry Tariq Gani, Sobia Manzoor, Khalid Sofi

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i8.27

Abstract

Background: Laryngoscopy and tracheal intubation increase blood pressure (BP) and heart rate (HR). The aim of this study was to evaluate the effect of gabapentin and labetalol given before operation on the hemodynamic response to laryngoscopy and intubation.

Methodology: 90 ASA I and II patients undergoing elective surgery were randomly allocated to three groups of 30 each. Group A patients received 800mg of Gabapentine orally 60 minutes before induction of anaesthesia, Group B patients received 100 mg oral Labetalol 60 minutes prior to induction of anaesthesia and Group C patients were not given any treatment and  served  as the control group for the study. Anesthesia was induced with inj. propofol and inj. rocuronium. Heart rate, systolic BP, diastolic BP and mean arterial pressure were recorded as baseline, after induction, at tracheal intubation (0 min.); and then at 1, 3, 5, 10 min following tracheal intubation.

Results: mean heart rate, mean systolic blood pressure, mean diastolic blood pressure and mean arterial blood pressure remained significantly lower in group A as compared to group B and group C.

Conclusions: Gabapentin, under present study design, attenuates the pressor response associated with laryngoscopy and intubation.

Keywords: Intubation; Laryngoscopy; Gabapentin, Labetalol.

References

  1. Pyrs-Roberts C and Greane LT. Studies of anaesthesia in relation to hypertension ,haemodynamic consequences of induction and endotracheal intubation.Br J Anaesthesia 1971:43:531-46.
  2. Prys-Roberts C and Foex P. Studies of anaesthesia in realtion to hypertension adrengergic beta receptor blockade .Anaesthesia 1973; 45:671-80.
  3. Scott, D.B., Buckely, F.P., Littlewood, D.G., Macrae, W.R., Arthur, G.R. & Drummond, G.B. (1978). Circulatory effects of labetalol during halothane anaesthesia. Anaesthesia, 33, 145-56.
  4. Coleman AJ. Cardiovascular response to anaesthesia Anaesthesia 1980; 35: 972-78
  5. Miller DR, Martineau RJ, Wynands JE, Hill J. Bolus administration of esmolol for controlling the haemodynamic response to trachealintubation: the Canadian multic-enter trial. Can J Anaesth 1991;38: 849-58.
  6. Chung KS, Sinatra RS, Chung JH. The effect of an intermediate dose of labetalol on heart rate and blood pressure response to laryngoscopy and intubation. B. J Clin Anesth 1992;4:11-5.
  7. Turan A, Karamanlo lu B, Memi D, Usar P, Pamukçu Z, Türe M. The analgesic effects of gabapentin after total abdominal hysterectomy. Anesth Analg (2004) 98:1370–3.
  8. Memis D, Turan A, Karamanlioglu B, Seker S, Ture M. Gabapentin reduces cardiovascular responses to laryngoscopy and tracheal intubation. Eur J Anaesthesiol 2006;23:686–90
  9. Fassoulaki A, Melemeni A, Paraskeva A, Petropoulos G. Gabapentin attenuates the pressor response to direct laryngoscopy and tracheal intubation. Br J Anaesth. 2006 Jun;96(6):769-73.
  10. Kong VKF AND Irwin MG. Gabapentine: A Multimodal Perioperative drug BR J Anaesthesia 2007 99(6):775-86.
  11. Kim HY, Chung CW, Lee HY, Yim CH. The Effect of labetalol on the hemodynamic response to endotracheal intubation. Korean J Anesthesiol.  1994; 27:1611–9.
  12. Amar D, Shamoon H, Frishman WH et al. Effect of Labetalol on perioperative stress markers and isoflurane requirements. Br j Anaesthesia;67;296-30.
  13. Chung KS, Sinatra RS, Chung JH. The effect of an intermediate dose of labetalol on heart rate and blood pressure response to laryngoscopy and intubation. B. J Clin Anesth 1992;4:11-5.
  14. Ramanathan J, Sibai B M, Mabie W C, Chauhan D and Ruiz A G 1988. The use of labetalol for attenuation of hypertensive response to endotracheal intubation in preeclampsia. Am. J. Obstet. Gynecol., 159(3), 650-4.

Corresponding Author

Tantry Tariq Gani

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.