Shrestha B R, Gautam B, Shrestha S, Maharjan S K
Department of Anesthesiology and ICU, Kathmandu Medical College Teaching Hospital, Sinamangal, Nepal.
J Nepal Health Res Counc. 2012 Jan;10(1):41-6.
The aim of the study is to investigate the effect of oral gabapentin or clonidine versus placebo premedication on haemodynamic and endocrine responses in patients of American Society of Anesthesiology (ASA) physical status I and II undergoing laparoscopic cholecystectomy.
This was a randomized prospective double-blinded comparative study of 75 ASA I and II patients with three groups: clonidine, gabapentin and placebo group having 25 patients in each. They were randomly allocated to receive 600 mg oral gabapentin or clonidine 150 mcg one hour prior to induction of anesthesia and a placebo group. Hemodynamic parameters were recorded before pneumoperitonium (PP) and every 5 minutes till 35 minutes of post PP. Blood samples for serum glucose and cortisol were collected before PP and 10 mins after PP. The investigators were blinded to what the patients received.
With similar demographic profiles and baseline haemodynamics in three groups (p>0.05) significant rise in haemodynamic parameters were observed in placebo group at different time points before and following PP where as those parameters remained stable in gabapentin and clonidine group (p<0.05). The serum cortisol level was high in placebo group before PP than in two other groups, p<0.05. The same marker measured at 10th minute after PP was significantly higher in placebo group than that in clonidine or gabapentin group, p<0.05.
Oral clonidine or gabapentin premedication offers intraoperative haemodynamic stability in laparoscopic cholecystectomy. When serum cortisol is taken as a stress marker, gabapentin group exhibited significant attenuation of stress of PP, p<0.05.
本研究旨在调查口服加巴喷丁或可乐定与安慰剂进行术前用药对美国麻醉医师协会（ASA）身体状况为I级和II级的行腹腔镜胆囊切除术患者的血流动力学和内分泌反应的影响。
这是一项针对75例ASA I级和II级患者的随机前瞻性双盲对照研究，分为三组：可乐定组、加巴喷丁组和安慰剂组，每组25例。在麻醉诱导前1小时，他们被随机分配接受600毫克口服加巴喷丁或150微克可乐定，还有一组接受安慰剂。在气腹（PP）前以及PP后每5分钟记录一次血流动力学参数，直至PP后35分钟。在PP前和PP后10分钟采集血清葡萄糖和皮质醇的血样。研究人员对患者所接受的治疗不知情。
三组患者的人口统计学特征和基线血流动力学相似（p>0.05），在PP前后的不同时间点，安慰剂组的血流动力学参数显著升高，而加巴喷丁组和可乐定组的这些参数保持稳定（p<0.05）。PP前，安慰剂组的血清皮质醇水平高于其他两组，p<0.05。PP后10分钟测量的同一指标，安慰剂组显著高于可乐定组或加巴喷丁组，p<0.05。
口服可乐定或加巴喷丁进行术前用药可在腹腔镜胆囊切除术中提供术中血流动力学稳定性。以血清皮质醇作为应激标志物时，加巴喷丁组对PP应激有显著减轻作用，p<0.05。
