The role of Gabapentin oral solution in decreasing desflurane associated emergence agitation and delirium in children after stabismus surgery, a prospective randomized double-blind study

Ahmed A Badawy,Tarek Al Menesy,Ghada Adel,Yasmin A Badawy,Samaa A Kasem,Doaa Rashwan,Ali M Mokhtar

doi:10.1186/s12871-018-0533-5

Ahmed A Badawy, Tarek Al Menesy + Show 5 more

Open Access

https://doi.org/10.1186/s12871-018-0533-5

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Journal: BMC Anesthesiology	Publication Date: Jun 20, 2018
Citations: 12	License type: open-access

Affiliation: Beni-Suef University, Cairo University

Abstract

BackgroundShort acting inhalational anesthetic (Desflurane) produces emergence agitation (EA) in pediatrics with an incidence up to 80%. The aim of the present study was to examine the role of Gabapentin oral solution in attenuating desflurane associated EA in children after strabismus surgery under general anesthesia.MethodsSeventy patients, 2–6 years old, scheduled for strabismus surgery were randomly allocated into two groups (35 each); Control group (c): received 5 ml of oral strawberry juice (placebo) and Gabapentin group (G) received 5 mg/Kg gabapentin oral solution in 5 ml strawberry juice, 1 h before anesthesia. Patient separation, cooperation, emergence incidence and emergence severity were assessed. Also time to extubation and time to emergence, duration of PACU stay, PONV and number of patients required meperidine postoperatively were recorded.ResultsDuration to extubation and duration to emergence were statistically prolonged in gabapentin group compared to the control group. The incidence of EA and its severity were reduced in gabapentin group with more tendencies to be asleep and less attentive. More patients in the control group required postoperative meperidine to reduce crying and agitation.ConclusionOral gabapentin 5 mg/kg reduced the incidence and severity scoring of emergence agitation (by 20%) with more tendencies for sleeping with preserved response to stimuli in PACU.Trial registrationNumber: NCT03347916, date: November 17, 2017, retrospectively.

Highlights

Short acting inhalational anesthetic (Desflurane) produces emergence agitation (EA) in pediatrics with an incidence up to 80%
Emergence agitation (EA) and emergence delirium (ED) in pediatrics during recovery from general anesthesia has been defined as a state of dissociated consciousness with excitement, irritability, uncooperation, thrashing, crying, moaning or incoherence [1, 2]
To our knowledge there were no reports evaluating the effect of gabapentin on emergence agitation after desflurane, the aim of this study was to evaluate the effect of preoperative oral gabapentin 5 mg/kg given 1 h before surgery on emergence agitation after desflurane anesthesia in children after strabismus surgery

Summary

Introduction

Short acting inhalational anesthetic (Desflurane) produces emergence agitation (EA) in pediatrics with an incidence up to 80%. The aim of the present study was to examine the role of Gabapentin oral solution in attenuating desflurane associated EA in children after strabismus surgery under general anesthesia. Inhalational anesthetics when used in pediatric patients undergoing surgery under general anesthesia can often. Gabapentin, a gamma-aminobutyric acid analog, binds the voltage-gated calcium channels of the dorsal root ganglion, at α2-δ subunit [7] Gabapentin binding to these channels inhibits the release of excitatory neurotransmitters preventing the propagation of painful stimuli which makes its use attractive in treatment of postoperative pain and agitation with less side effects compared with opioids and benzodiazepines [8].

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