Comparative study of oral gabapentin, pregabalin, and clonidine as premedication for anxiolysis, sedation, and attenuation of pressor response to endotracheal intubation

Waikar, Chandrakant; Singh, Jaideep; Gupta, Deepesh; Agrawal, Amit

doi:10.4103/aer.aer_34_17

Cited by 18 publications

(11 citation statements)

References 5 publications

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“…It was found that 1 µg kg -1 dexmedetomidine group had higher incidence of hypotension than other two groups but in our study administration of 1 µg kg -1 dexmedetomidine did not produce any significant hypotension. Waikar et al (9) proved that gabapentin, clonidine and pregabalin attenuated blood pressure and heart rate. In their study they concluded that all three drugs were very effective in relieving anxiety and improving sedation.…”

Section: Discussionmentioning

confidence: 99%

Attenuation of Hemodynamic Response to Tracheal Intubation with Pregabalin and Dexmedetomidine - A Prospective Randomized Double Blinded Study

Sambandam¹,

Chandrasekran²,

Dhanasekaran³

et al. 2020

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Objective: Airway manipulation during endotracheal intubation is a potential stimulus and it is associated with untoward hemodynamic changes. The aim of this study was to compare the efficacy of intravenous dexmedetomidine and oral pregabalin premedication for attenuation of hemodynamic pressor response to laryngoscopy and intubation. Methods: A total of 60 patients of age group of 18-60 years scheduled for elective surgeries under general anesthesia with ASA physical status I were randomized into two groups. Group D received intravenous dexmedetomidine at a dose of 1 µg kg-1 over 10 minutes before induction and group P received oral pregabalin 150 mg one hour prior to intubation. The primary outcomes, heart rate and mean arterial pressure noted at serial intervals during intubation were compared between the groups. Sedation score was assessed as secondary outcome using Richmond Agitation Sedation Scale Scores (RAAS). Results: Group D and P were comparable with distribution of age, sex and duration of laryngoscopy. The mean heart rates and mean arterial pressures assessed at serial measurements at 0, 1, 3, 5, 10 minutes post-intubation were statistically significant (p=0.005) in dexmedetomidine group when compared to pregabalin group. The RASS scores assessed at 15, 30 and 60 minutes post-extubation were statistically significant (p<0.05) in pregabalin group when compared to dexmedetomidine group. Conclusion: Intravenous dexmedetomidine at a dose of 1 µg kg-1 is more effective than oral pregabalin 150 mg in attenuating hemodynamic response to laryngoscopy and orotracheal intubation. Post-procedural sedation was better achieved with oral pregabalin compared to intravenous dexmedetomidine.

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Section: Discussionmentioning

confidence: 99%

Attenuation of Hemodynamic Response to Tracheal Intubation with Pregabalin and Dexmedetomidine - A Prospective Randomized Double Blinded Study

Sambandam¹,

Chandrasekran²,

Dhanasekaran³

et al. 2020

jarss

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“…Oral pregabalin in a dose of 300mg was a better premedicant compared to 150mg as it not only blunted the arterial pressor response to laryngoscopy and intubation, but also provided anxiolysis with reduction of intra-operative anaesthetic drug requirement and maintained haemodynamic stability without significant adverse effects. Waikar C et al 16 compared oral gabapentin, pregabalin, and clonidine as premedication for anxiolysis, sedation, and attenuation of pressor response to endotracheal intubation. They concluded that for attenuation of pressure response for orotracheal intubation, pregabalin was better than gabapentin and clonidine.…”

Section: Discussionmentioning

confidence: 99%

Study to determine the effect of oral pregabalin premedication on haemodynamic response to laryngoscopy, intubation and carbon dioxide insufflation during laparoscopic cholecystectomy

Allu

Kulkarni

Dinesh

2019

Sri Lankan J Anaesthesiol

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Background:The process of laryngoscopy and endotracheal intubation is usually associated with exaggerated haemodynamic response. In extreme cases this response may result in myocardial ischaemia, cardiac failure, increase in intracranial pressure and intracranial haemorrhage. Hence our prospective randomized double blinded placebo control study was designed to observe the effect of pregabalin in attenuating this haemodynamic response. Method:In this study, 100 adult patients of ASAPS I and II undergoing elective laparoscopic cholecystectomy were included. The patients were randomly allocated into two groups, group P received 150mg oral pregabalin and group C received similarly looking B complex capsules one hour before the surgery. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) were observed. Sedation score was assessed using Ramsay sedation scale. Results:We observed an increase in all the haemodynamic parameters in both the groups. The percentage change in HR and MAP from baseline at one-minute following intubation was +33% and +28.5% in control group compared to +14% and +3% in pregabalin group. Similarly, the percentage change at five minutes after carboperitoneum was +24% and +26% in control group compared to +4% and +0.8% in pregabalin group. This difference was statistically significant with P value <0.05. We also found all the patients in acceptable sedation state (score 3 and 4 based on Ramsay sedation scale) in pregabalin group whereas only 40% patients had a score of 3 in placebo group at 15minutes following extubation. Conclusion:Oral pregabalin in a dose of 150mg one hour before the surgery is a safe and effective premedicant in attenuating pressor response to laryngoscopy, intubation and laparoscopy. It also produces good sedation without any adverse effects.

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“…Following anxiety and sedation scores were used: anxiety score :( 0patient quiet and comfortable; 1-patient uneasy; 2-patient worried or anxious ; 3-patient very worried or very upset). 13 Sedation score used was (1-wide awake; 2sleeping comfortably but responding to verbal commands; 3-deep sleep but arousable, 4-deep sleep but not arousable).…”

Section: Exclusion Criteriamentioning

confidence: 99%

“…12 Clonidine is an alpha-2 adrenergic agonist which has been used for many years as an antihypertensive and as negative chronotropic agent. 13 During general anaesthesia clonidine enhances intraoperative circulatory stability by reducing catecholamine levels. 14 It has many properties of an ideal premedicant and also has beneficial effects on haemodynamics during stressful conditions like laryngoscopy and endotracheal intubation.…”

Section: Introductionmentioning

confidence: 99%

A comparative study of efficacy of oral pregabalin and clonidine for attenuation of pressor response to intubation

Kaur

Gupta

Singh

et al. 2021

Int J Basic Clin Pharmacol

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Background: Endotracheal intubation is associated with hemodynamic stress responses. Various drugs have been used in the past to attenuate the pressor response; however, none has been proved to be ideal. Present study was planned to evaluate the oral pregabalin 150 mg and clonidine 200 µg for attenuation of pressor response to intubation.Methods: The study was conducted on 100 adult patients of either gender scheduled to undergo elective surgeries under general anaesthesia (GA). The patients were randomly allocated into 2 groups. In group A patients received pregabalin 150mg and in group B patients received clonidine 200µg orally. The hemodynamic parameters were recorded until 10 minutes after intubation. The sedation, anxiety and side effects were also assessed.Results: In clonidine group, the mean HR remained below the baseline value at all the time intervals. In pregabalin group, the mean HR remained below the baseline value at most of the time intervals but increased above baseline just after intubation (T0i) and 1 minute after intubation (T1i) where increase was only 1.488±1.20% and 0.45±1.16% respectively from baseline. In both pregabalin and clonidine groups, the mean SBP and MAP remained below the baseline value (Tb) at all the time intervals from T0.5 to T10i. Both clonidine and pregabalin provided adequate anxiolysis and sedation with pregabalin providing more pronounced sedation and anxiolysis than clonidine.Conclusions: Both clonidine and pregabalin are effective oral premedication drugs for attenuation of the pressor response to laryngoscopy and endotracheal intubation.

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Comparative study of oral gabapentin, pregabalin, and clonidine as premedication for anxiolysis, sedation, and attenuation of pressor response to endotracheal intubation

Cited by 18 publications

References 5 publications

Attenuation of Hemodynamic Response to Tracheal Intubation with Pregabalin and Dexmedetomidine - A Prospective Randomized Double Blinded Study

Attenuation of Hemodynamic Response to Tracheal Intubation with Pregabalin and Dexmedetomidine - A Prospective Randomized Double Blinded Study

Study to determine the effect of oral pregabalin premedication on haemodynamic response to laryngoscopy, intubation and carbon dioxide insufflation during laparoscopic cholecystectomy

A comparative study of efficacy of oral pregabalin and clonidine for attenuation of pressor response to intubation

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