Abstract
Introduction: General anaesthesia is the gold standard anaesthetic technique for laproscopic appendicitis. However, this procedure is not risk free. Carbon dioxide is used to create pneumoperitoneum in laproscopic surgeries causes various hemodynamic changes such as abrupt elevation of arterial pressure, systemic vascular resistance and decreased cardiac output. These changes are well tolerated in healthy patients. There is also an increase in circulatory catecholamines during laryngoscopy and intubation. Many pharmacological techniques were evaluated either in the premedication or during the induction to attenuate the hemodynamic response to pneumoperitoneum such as – deepening the anaesthesia, pretreatment with vasodilators, adrenoceptor blockers, calcium channel blockers and opiods. This study is designed to evaluate the hemodynamic changes associated by laryngoscopy, tracheal intubation and pneumoperitoneum in laparoscopic appendicectomy by premedicating the patients with Gabapentin (900mg) and Pregabalin (150mg). Materials and Methods: The study was carried out as a hospital based double blinded randomized prospective comparative study after obtaining institutional ethics committee approval in the Department of Anaesthesiology, SMVMCH Puducherry. The sample size was calculated as 72 with 36 in each group. Patients scheduled for elective laparoscopic appendicectomy were selected for the study based on predetermined inclusion and exclusion criteria. The study drug, Gabapentin 900mg or Pregabalin 150mg, was sealed in a black covered envelope and was given to the patient with sips of water 1 hour before the induction of anaesthesia by an anaesthetist not involved in study. Anaesthetic and surgical techniques were standardized for all patients. HR, SBP, DBP, MAP, SpO2 were recorded at the following points of time:(i) Prior to induction, (ii) 2-3 minutes after intubation, (iii) Before creating pneumoperitoneum, (iv) After creating pneumoperitoneum, (v) 2 minutes after extubation, (vi) Intra op,every 5 mins till the end of surgery, (vii) Post op, every 10 mins for the 1st 30 minutes and then every 30 minutes till 3 hours, along with Ramsay sedation score.
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