Effect of Two Different Doses of Gabapentin on the Intraocular Pressure and Hemodynamic Stress Responses to Laryngoscopy and Tracheal Intubation

Amani A Ali,Ahmed Samir,Abeer M Elnakera

doi:10.1155/2013/698205

Abstract

Background. The stress response to laryngoscopy and intubation causes an undesirable increase in heart rate, blood pressure, and intraocular pressure. This study was designed to compare the effect of two doses of gabapentin on the stress response to laryngoscopy and intubation.Patients and Methods. (ASA I and II) 60 patients, aged from 18 to 60 years undergoing elective eye surgery requiring endotracheal intubation, were randomly allocated into 3 groups, 20 patients each. 2 hours before the surgery, group I received oral placebo, and groups II and III received oral gabapentin 800 mg and 1200 mg, respectively. Heart rate (HR), mean arterial pressure (MAP), and intraocular pressure (IOP) were measured before and after induction of anesthesia, immediately after, 5 minutes, and 10 minutes after intubation.Results. Gabapentin 1200 mg prevented the increase in HR, MAP, and IOP, secondary to laryngoscopy and intubation, and kept them below the baseline till 10 minutes after intubation (), while with gabapentin 800 mg, the increase in HR, MAP, and IOP was nonsignificant () and returned to levels below the baseline at 5 and 10 minutes after intubation.Conclusion. Preoperative gabapentin 1200 mg effectively prevented the stress response to laryngoscopy and intubation; meanwhile, gabapentin 800 mg only prevented significant stress response.

Highlights

Laryngoscopy and endotracheal intubation can evoke a transient but marked response manifested as hemodynamic changes such as hypertension, tachycardia, even dysrhythmias, and an increase in intraocular pressure [1, 2].The hemodynamic responses to laryngoscopy and intubation can be tolerated by a normal subject but they may be dangerous increasing the morbidity and mortality in patients with hypertension and ischemic heart disease [3].The control of intraocular pressure (IOP) is of prime importance in eye surgery especially in penetrating eye injury and glaucoma surgery [4]
Data were expressed as mean ± SD. #Means that control group was significantly different from both groups (P < 0.05). @Means that gabapentin 800 group was significantly different from gabapentin 1200 group (P < 0.05). ∗Means significant difference from baseline value (P < 0.05). ∗∗Means highly significant difference from baseline value (P < 0.001)
The present study showed that gabapentin 1200 mg given to the patient 2 hours before surgery effectively prevented the increase in Heart rate (HR), mean arterial pressure (MAP), and IOP secondary to laryngoscopy

Summary

Background

The stress response to laryngoscopy and intubation causes an undesirable increase in heart rate, blood pressure, and intraocular pressure. This study was designed to compare the effect of two doses of gabapentin on the stress response to laryngoscopy and intubation. Heart rate (HR), mean arterial pressure (MAP), and intraocular pressure (IOP) were measured before and after induction of anesthesia, immediately after, 5 minutes, and 10 minutes after intubation. Gabapentin 1200 mg prevented the increase in HR, MAP, and IOP, secondary to laryngoscopy and intubation, and kept them below the baseline till 10 minutes after intubation (P < 0.001), while with gabapentin 800 mg, the increase in HR, MAP, and IOP was nonsignificant (P > 0.05) and returned to levels below the baseline at 5 and 10 minutes after intubation. Preoperative gabapentin 1200 mg effectively prevented the stress response to laryngoscopy and intubation; gabapentin 800 mg only prevented significant stress response

Introduction

Patients and Methods

Results

Discussion