Kaya F N, Yavascaoglu B, Baykara M, Altun G T, Gülhan N, Ata F
Department of Anesthesiology and Reanimation, Uludag University Medical School, Bursa, Turkey.
Acta Anaesthesiol Scand. 2008 Sep;52(8):1076-80. doi: 10.1111/j.1399-6576.2008.01627.x.
Laryngoscopy and tracheal intubation may cause undesirable increases in blood pressure, heart rate (HR) and intraocular pressure (IOP). Gabapentin has been used effectively to attenuate the pressor response to laryngoscopy and tracheal intubation. We investigated whether the pre-treatment with gabapentin attenuates the IOP in addition to a haemodynamic response to tracheal intubation.
Sixty ASA I-II patients were randomly allocated into two groups who received either gabapentin (800 mg) or placebo 2 h before surgery. IOP, mean arterial pressure (MAP) and HR were measured before and after the induction of anaesthesia as well as at 0, 1, 3, 5, 10 and 15 min following intubation.
IOP and MAP increased from baseline immediately after intubation in the placebo group (P=0.001 and 0.002, respectively). When compared with the placebo group, IOP values of the gabapentin group were significantly lower for the first 15 min after tracheal intubation (P=0.002 at 0 min, P=0.006 at 1 min, P<0.001 at 3 min, P<0.001 at 5 min, P<0.001 at 10 min and P=0.003 at 15 min) while MAP was lower in the first 10 min (P=0.001 at 0 min, P=0.002 at 1 min, P<0.001 at 3 min, P<0.001 at 5 min and P=0.028 at 10 min). These results showed that gabapentin effectively suppresses the increase in IOP secondary to endotracheal intubation and attenuates the increases in MAP.
It is suggested that gabapentin is a useful adjuvant in order to prevent an increase in the IOP in response to laryngoscopy and tracheal intubation.
喉镜检查和气管插管可能导致血压、心率(HR)和眼压(IOP)出现不良升高。加巴喷丁已被有效用于减轻喉镜检查和气管插管引起的升压反应。我们研究了加巴喷丁预处理除了对气管插管的血流动力学反应外,是否还能减轻眼压。
60例美国麻醉医师协会(ASA)分级为I-II级的患者被随机分为两组,分别在手术前2小时接受加巴喷丁(800毫克)或安慰剂。在麻醉诱导前后以及插管后0、1、3、5、10和15分钟测量眼压、平均动脉压(MAP)和心率。
安慰剂组插管后眼压和MAP立即从基线升高(分别为P = 0.001和0.002)。与安慰剂组相比,加巴喷丁组在气管插管后的前15分钟眼压值显著较低(0分钟时P = 0.002,1分钟时P = 0.006,3分钟时P < 0.001,5分钟时P < 0.001,10分钟时P < 0.001,15分钟时P = 0.003),而MAP在前10分钟较低(0分钟时P = 0.001,1分钟时P = 0.002,3分钟时P < 0.001,5分钟时P < 0.001,10分钟时P = 0.028)。这些结果表明加巴喷丁有效抑制气管插管继发的眼压升高,并减轻MAP升高。
提示加巴喷丁是预防喉镜检查和气管插管引起的眼压升高的有用辅助药物。