Gabapentin as add-on to fentanyl and midazolam in patients receiving mechanical ventilation: a randomized, blinded study

Abstract

Background: Fentanyl and midazolam are used in management of patients requiring mechanical ventilation. They are usually associated with important unwanted effects. Gabapentin has sedative and analgesic effects. Our purpose was to study gabapentin addition on total consumption of fentanyl and midazolam in patients receiving mechanical ventilation. Methods: This randomized and double-blinded trial was conducted in ICU of a general hospital, Tehran, Iran. Fifty patients aged from 18 to 70 years were randomized 1:1 to 300 mg gabapentin q8hr plus 0.5 - 2 µg/kg/hour fentanyl and 0.05 - 0.1 mg/kg/hour midazolam or identical placebo plus 0.5 - 2 µg/kg/hour fentanyl and 0.05 - 0.1 mg/kg/hour midazolam. Daily use of fentanyl and midazolam were measured. Ramsay sedation score was used for evaluation of sedation. Results: A total of 43 patients were studied. Both treatment modalities reached the target sedation level. Mean total dose of midazolam was 3.9 ± 2.1 mg in the control group and 2.3 ± 2.1 mg in the intervention group (P Conclusion: This trial showed that add-on therapy with gabapentin can significantly reduce total consumption of fentanyl and midazolam in patients receiving mechanical ventilation. Gabapentin addition to fentanyl and midazolam has no significant impact on duration of ventilation and length of ICU stay.