Abstract : Laryngoscopy and subsequent tracheal intubation causes a fugitive tachycardia and hypertension as a result of sympathoadrenal stimulation. Many modalities have been proposed and practiced to attenuate this pressor response to laryngoscopy and intubation. It includes both pharmacological and non-pharmacological methods. This randomized double blind prospective study had been designed to compare the efficacy of oral gabapentin 800mg, IV fentanyl 2 µg/kg and a combination of both the drugs in obtunding the hemodynamic responses such as HR, SBP, DBP & MAP during laryngoscopy and intubation and also to observe the adverse effects of the above mentioned study drugs, if any. After approval from medical ethics committee, Dr D Y Patil Medical College and Hospital, Pune, the study was carried out on seventy-five (75) patients undergoing elective surgeries under standard general anaesthesia after obtaining consent from the patients. Group G patients received cap. gabapentin 800mg 2h prior to intubation, Group F patients received Inj. fentanyl 2µg/kg IV given 5mins prior to intubation, Group GF patients received Cap. gabapentin 800mg given 2h prior to intubation and Inj. fentanyl 2µg/kg IV given 5mins prior to intubation. All hemodynamic measurements like HR, SBP, DBP & MAP were recorded at 1 min, 3 min, 5 min, 10 min & 15 min after intubation. The patients were monitored for any adverse effects of the drugs. There was no statistically considerable difference between the study groups with respect to baseline parameters of HR, SBP, DBP, MAP and SpO2.There was substantial difference in mean HR, SBP, DBP & MAP values at laryngoscopy, at 1, 3, 5, 10 and 15mins following laryngoscopy and intubation between the three groups. Patients belonging to group GF showed significant attenuation of all the above said parameters effectively and the values were statistically significant when compared to other groups. (p < 0.05). The observed side effects were minimal and not significant statistically (p > 0.05). Based on the current clinical study, Oral gabapentin 800mg given 2 hours prior to intubation along with fentanyl at dose of 2µg/kg IV given 5mins before intubation is effective in attenuating the hemodynamic responses to laryngoscopy and tracheal intubation when compared to individual administration of either oral gabapentin 800mg or IV fentanyl 2µg/kg. Incidence of adverse effects is very less in all three groups and was not statistically significant..
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