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There are three major components of vomit reflex, the emetic detectors, integrative mechanism, and motor output. The main sensors of somatic stimuli are located in the gut and chemo-receptor trigger zone (CTZ). The emetic stimuli in gut are detected by two types of vagal afferent fibers. Mechanoreceptors They are located in the muscular wall of the gut and are activated by contraction and distension of the gut, on physical damage and manipulation during surgery.

Background: Laryngoscopy and endotracheal intubation are associated with an increase in blood pressure (BP) and heart rate (HR). The present study was conducted to evaluate the role of gabapentin in attenuation of these hemodynamic changes. Methods: Forty patients undergoing elective laparoscopic cholecystectomy under general anesthesia with standardized premedication and anesthetics were randomized to receive gabapentin or a matching placebo. The patients of Group I received gabapentin 600 mg orally 2 hrs before surgery and patients in Group II received a matching placebo. Patient's HR, systolic BP (SBP), diastolic BP (DBP), mean BP (MBP), were monitored before and after 1, 2, 5, and 10 mins of endotracheal intubation. Results: Comparison of SBP, DBP, and MBP at 1, 2, 5 and 10 mins after endotracheal intubation showed statistically significant attenuation in the gabapentin group when compared to placebo. Changes in the HR were not significant. Conclusion: Gabapentin 600 mg, given 2 hrs before induction is effective in attenuating the pressor response to laryngoscopy and tracheal intubation.

Background: Post-menopausal women suffer from various complications like autonomic dysfunction which predisposes them to cardiovascular morbidity. Decline in estrogen levels after menopause is associated with increased cardiovascular risks. Timely evaluation of such derangements and active intervention can play an important role in the prevention of cardiovascular morbidity. Aims and Objective: The aim is to compare the sympathetic autonomic nervous system activity in pre-menopausal and age-matched post-menopausal women. Materials and Methods: This study was conducted on two groups of 40 women each. Group I included pre-menopausal women and Group II included post-menopausal women. Sympathetic nervous system assessment was done using cold pressor test (CPT), handgrip test (HGT), and blood pressure (BP) response to standing. Statistical analysis was performed using Student's t-test. Results: Evaluation of sympathetic functions between the two groups showed that the mean rise in systolic BP (SBP) in response to CPT was lower in Group I than in Group II (P < 0.01). Mean rise in the diastolic BP (DBP) in response to HGT was also lower in Group I as compared to Group II (P < 0.01). Fall in SBP on standing in Group I was more than in Group II (P < 0.01). Conclusion: Sympathetic nervous system evaluation showed sympathetic hyperactivity in the post-menopausal group as compared to the premenopausal group.

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