ORAL PREGABALIN PREMEDICATION FOR ATTENUATION OF HEMODYNAMIC PRESSURE RESPONSE OF AIRWAY INSTRUMENTATION DURING GENERAL ANAESTHESIA: DOSE RESPONSE STUDY

Dr Mitali Vilas Patkar; Dr Poornima Ashwin Sonkamble; Dr Ashwin Pralhad Sonkamble

Volume : VIII, Issue : IX, September - 2018

ORAL PREGABALIN PREMEDICATION FOR ATTENUATION OF HEMODYNAMIC PRESSURE RESPONSE OF AIRWAY INSTRUMENTATION DURING GENERAL ANAESTHESIA: DOSE RESPONSE STUDY

Dr Mitali Vilas Patkar, Dr Poornima Ashwin Sonkamble, Dr Ashwin Pralhad Sonkamble

Abstract :

Introduction: Entotracheal intubation is one of the most frequently performed procedure in anaesthesia practice involving general anaesthesia. The process of laryngoscopy and intubation produces noxious stimuli and is associated with intense sympathetic activity marked by tachycardia and hypertension. Various methods and drugs have been used to attenuate this haemodynamic response which includes use of LMA, nerve blocks, inhalational agents, topical and intravenous lignocaine, calcium channel blockers, narcotics, vasodilators, Pregabalin , gabapentine etc.

New agent Pregabalin, primarily used as anticonvulsant has been found to have reduced haemodynamic respone to airway instrumentation.. so we compared the effect of 2 different doses of Pregabalin(75 mg & 150 mg ) to the laryngoscopy and intubation response.

Patients and Methods: After obtaining approval of institutional ethical committee, a prospective randomized study was conducted on 90 patients divided in 3 groups of 30 each. Group A received Placebo ie multivitamin tab. Group B received 75mg of Pregabalin and Group C received 150mg of Pregabalin 1 hour prior to induction of anaesthesia. Inside the OT, pts were premedicated with Ondensetron, Midazolam, Glycopyrrolate and Fentanyl and induced with propofol. Under the effect of Vecuronium, laryngoscopy and intubation was done and anaesthesia was maintained with Oxygen, Nitrous oxide, Sevoflurane and intermittent Vecuronium on controlled ventilation to maintain normocapnia. Haemodynamic parameters were noted.

Conclusion: After statistical analysis we have found that group C (150 mg Pregabalin) showed highly significant attenuation of sympathetic responses and in group B (75 mg Pregabalin), there was transient increase in all the hemodynamic parameters which were settled down in 5–10 minutes period but this increase was still less than placebo group A.