COMPARISON OF GABAPENTIN AND LORAZEPAM AS PREMEDICATION TO ATTENUATE THE PRESSOR RESPONSE TO INTUBATION IN CARDIAC PATIENTS UNDERGOING CORONARY ARTERY BYPASS GRAFT SURGERY; A RANDOMIZED CONTROLLED TRIAL

Abstract

Objective: To determine the efficacy of Gabapentin and Lorazepam as premedication to reduce the presser response to intubation in cardiac patients undergoing CABG surgery.

Study Design: Randomized control trial.

Place and Duration of Study: Adult cardiac anesthesia department of Armed Forces Institute of Cardiology, Rawalpindi, from Nov 2017 to Feb 2018.

Material and Methods: This double blinded randomized clinical trial was carried out on 110 patients scheduled for elective CABG under general anesthesia with endotracheal intubation. Patients were divided into two equal groups, where group A patients received 300mg of Gabapentin (Gabix) R in one dosage and group B received 2mg of Lorazepam (Ativan) R in one dosage, 4 hours before shifting to OT. Patient’s hemodynamic parameters including heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were recorded before induction of anaesthesia (baseline) and at 1, 5 and 10 minutes after tracheal intubation.

Results: There was no significant difference in the baseline hemodynamic parameters of the patients in two groups, the inter-group comparison showed significantly higher HR, SBP, DBP and MAP at 1, 5 and 10 minutes after tracheal intubation in group B (lorazepam) patients (p<0.05).

Conclusion: Premedication with 300 mg of oral Gabapentin four hour before surgery better attenuates the hemodynamic response to laryngoscopy & intubation in comparison to 2mg of oral Lorazepam.