Gabapentin [structural analog of
GABA], is an
antiepileptic drug that its preoperative
administration results in
postoperative pain reduction. Considering the
hypnotic effect of
propofol, which is mediated by its attachment to GABAA, this hypothesis was propounded that
administration of
gabapentin can probably decrease the need for
propofol and
remifentanil during total
intravenous anesthesia. Fifty
patients scheduled for elective
laparoscopic cholecystectomy, were assigned into two equal groups [n=25] in this randomized double blinded
clinical trial. Study group received oral
gabapentin [1200mg], and
control group received placebo 3hrs before operation.
Premedication and induction of
anesthesia were the same in all
patients. For the
maintenance of
anesthesia,
oxygen and
nitrous oxide [50%-50% mixture] and
propofol and
remifentanil infusion were used. The rate of
propofol infusion was adjusted to maintain BIS in the range of 40- 60, and
dose of
remifentanil adjusted to maintain
hemodynamic variables in the range of +/- 20% of baseline values. At the end of
anesthesia the duration of
anesthesia and the total amount of
propofol and
remifentanil used for every
patient were recorded. The demographic
parameters were
similar in both groups [p>0.05]. Doses of
propofol and
remifentanil used for study group were significantly lower than doses used for
control group [p<0.01]. The mean values of baseline systolic, diastolic, mean arterial,
heart rates and BIS in the study group were lower than the corresponding values in the
control group [p<0.05]. This study showed that a
single dose of
gabapentin before operation can decrease the need for
propofol and
remifentanil in total
intravenous anesthesia during
laparoscopic cholecystectomy