Perioperative Administration of Gabapentin for Reducing Inhalational Anesthetic Consumption
Overview
Gabapentin, a structural analog of gamma aminobutyric acid (GABA), was introduced within the us as an anticonvulsant, used clinically to treat epilepsy. The drug causes amino acids release within the medulla spinalis dorsal horn and thus decreasing response to neural inputs and stabilizing the nervous activity. The mechanism of action of gabapentin on neuropathic pain is assumed to bind to the alpha 2 delta subunit of the voltage-dependent calcium channel within the central systema nervosum , reducing calcium influx into the nerve terminals and decreases the release of neurotransmitters like glutamate . Gabapentin, therefore, can be used for controlling chronic pain, as in diabetic neuropathy and other neuropathic disorders . Some studies examined the effectiveness of gabapentin for acute postoperative pain management for gynecological surgery, lumbar spinal surgery, arthroplasty, and thoracic surgery . A recent study concluded that gabapentin has a role in preoperative anxiolysis, attenuation of hemodynamic response to intubation, prevention of postoperative nausea and vomiting (PONV) and finally postoperative delirium . Up to date, the effect of preoperative gabapentin on inhaled anesthetic depth is unknown
Study Type
- Study Type: Interventional
- Study Design
- Allocation: Randomized
- Intervention Model: Parallel Assignment
- Primary Purpose: Treatment
- Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
- Study Primary Completion Date: June 13, 2023
Interventions
- Drug: oral gabapentin
- will be received oral gabapentin capsule 2 HOURS pre-operatively.
Arms, Groups and Cohorts
- Active Comparator: group I
- will be received oral gabapentin capsule 1200 mg 2h pre-operatively.
- Active Comparator: group II
- will be received oral gabapentin capsule 600 mg 2h pre-operatively.
- No Intervention: Group III
- will be received placebo capsules at 2 hours preoperatively.
Clinical Trial Outcome Measures
Primary Measures
- sevoflurane consumption
- Time Frame: 4 hours
- Intra-operative consumption of sevoflurane will be measured and recorded (ml/hr).
Secondary Measures
- nalbuphine consumption
- Time Frame: 24 hours
- postoperative nalbuphine consumption by mg
- Intraoperative fentanyl consumption.
- Time Frame: 6 hours
- Intraoperative fentanyl consumption by mic
Participating in This Clinical Trial
1. Inclusion criteria:
- Patients aged from 18 to 60 years. – ASA I-II. – Undergoing craniotomy for intracranial tumors. 2. Exclusion criteria:
- Patient refusal – Patients younger than 18 or above 60 years old – patients with (ASA) physical status ≥ III – patients with compromised cardiovascular, renal, hepatic or neurological function – Known allergy to study drug. – Contraindication or chronic use (consistent use for longer than 3 months) to any of the study drugs – Suffered from severe psychiatric disease or drug addiction; – History of parenteral or oral analgesic intake within the last 48hours
Gender Eligibility: All
Minimum Age: 18 Years
Maximum Age: 60 Years
Are Healthy Volunteers Accepted: Accepts Healthy Volunteers
Investigator Details
- Lead Sponsor
- Cairo University
- Provider of Information About this Clinical Study
- Principal Investigator: Amr Samir Wahdan, Lecturer of Anesthesia, Pain management and Surgical ICU – Cairo University
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