Comparative efficacy of oral gabapentin versus melatonin for attenuation of haemodynamic response to direct laryngoscopy and endotracheal intubation

Several drugs have been tried and used to attenuate the haemodynamic response to direct laryngoscopy and endotracheal intubation. In this study, we have compared the efficacy of Gabapentin and Melatonin, an endogenous hormone, in attenuating the haemodynamic response to direct laryngoscopy and endotracheal intubation. 60 patients of ASA physical status I and II scheduled to undergo elective surgeries were randomly allocated to three groups: the Control group, Melatonin group and Gabapentin group. Placebo, 6mg melatonin, or 300mg gabapentin respectively were administered orally to the patients in the three groups 120min before surgery. Pre-operative anxiety score, induction dose of propofol and the patient’s heart rate and blood pressure were recorded. The haemodynamic parameters were recorded every minute for 5 minutes after intubation and then at 10 and 15min after intubation. Patients in the study groups were found to have significantly reduced pre-operative anxiety scores and dose of propofol required for induction was also significantly lower than control. Heart rate was found to be significantly lower in the study groups at all time points. Systolic blood pressure was significantly lower in the study groups at 1, 2, 3, 4, 10 and 15min after intubation. Diastolic and Mean blood pressures were significantly lower in the study groups at 1 and 2min after intubation. Post-hoc tests showed no significant differences between the two study groups. Both melatonin and gabapentin are effective in attenuating the haemodynamic response to direct laryngoscopy and endotracheal intubation. Both drugs are also effective in reducing pre-operative anxiety and also reduce the induction dose of propofol.