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A comparative randomized study to evaluate the effect of gabapentin alone and in combination with labetalol in attenuating the pressor response to direct laryngoscopy and intubation

Shaista Yaqoob, Tantry Tariq Gani, Aabid Hussain Mir, Abida Yousuf, Abdul Waheed Mir, Shahnawaz Khaliq.

Background: Direct laryngoscopy and intubation are associated with the pressor response which leads to increase in blood pressure (BP) and heart rate (HR) which may be tolerated by young healthy individuals but can prove detrimental in elderly and comorbid patients. Hence, some premedication agents are administered to suppress these responses.

Objectives: In this study, we compared gabapentin and combination of gabapentin and labetalol with a placebo group to study their effect on attenuation of these pressor responses.

Materials and Methods: A total of 90 patients belonging to American Society of Anesthesiologists Class I and II were divided into three Groups A, B, and C of 30 patients each. 1 h before induction of anesthesia patients in Group A received gabapentin 800 mg and in Group B received 400 mg of gabapentin plus 50 mg of labetalol orally, while patients in Group C did not receive any drug and acted as control. Mean arterial pressure (MAP) and HR were recorded in all the three groups at baseline and at 0, 1, 3, 5, and 10 min after tracheal intubation.

Results: Demographic characteristics were comparable in all the three groups. The baseline HR and MAP were also comparable in all the three groups and were statistically insignificant (P > 0.05). However, after tracheal intubation, there was significant increase in HR and MAP in the control Group (C), whereas in Group A and B the response was attenuated and was statistically significant (P = 0.05). Among the two study groups, BP was better attenuated by gabapentin, whereas the combination of gabapentin and labetalol abolishes HR response better.

Conclusion: We conclude gabapentin alone and in combination with labetalol attenuates the hemodynamic response to laryngoscopy and intubation.

Key words: Laryngoscopy; Intubation; Gabapentin; Labetalol; Pressor Response

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