Attenuation of the hemodynamic response to tracheal intubation with gabapentin and oral midazolam

Abstract

Objective: Endotracheal intubation is associated with hemodynamic response that may be serious in high-risk patients. This study compared oral gabapentin 900 mg alone or with 7.5 mg oral midazolam on the hemodynamic responses to direct laryngoscopy and endotracheal intubation (LETI).

Methodology: This randomized, double-blind clinical trial was conducted in operating room complex, National Cancer Institute, Cairo University, Cairo. The study included 60 normotensive adults scheduled for modified radical mastectomy under general anesthesia. The participants were randomly allocated to two equal groups to receive premedication either with oral gabapentin 900 mg (Group G) or gabapentin 900 mg plus 7.5 mg midazolam (Group GM). Sedation was monitored up to the time of induction of anesthesia. Heart rate (HR) and systolic and diastolic blood pressures were recorded up to 30 min of laryngoscopy.

Results: In the two groups, systolic and diastolic blood pressure and heart changes were controlled up to 30 min intra-operatively. Systolic and diastolic blood pressure were significantly lower in Group GM compared to Group G. At all times, there was no significant difference in heart rate between the two groups.

Conclusion: Oral gabapentin is effective in attenuation of the hypertensive response to laryngoscopy and endotracheal intubation when administered in a dose of 900 mg 90 min before modified radical mastectomy. It is more effective when combined with oral midazolam 7.5 mg.

Citation: Bakeer AH, Abdallah NM. Attenuation of the hemodynamic response to tracheal intubation with gabapentin and oral midazolam. Anaesth. pain & intensive care 2019;23(1):37-42