Bölgesel anestezi ile karotis endarterektomide gabapentinin i?ntraoperatif kooperasyon, stres yanit ve postoperatif analjezi üzerine etkileri

Abstract

Objective: The aim of this study was to evaluate the effects of gabapentin on intraoperative cooperation, surgical stres response, and postoperative analgesia in patients undergoing carotid endareterctomy (CEA) with regional anesthesia. Material and Methods: After approval of the Ethics Committee of the hospital, and patients' informed consents were obtained, 34 ASA 2-3 patients over 50 years of age who were scheduled for elective CEA under regional anesthesia were randomly assigned to one of the two groups. Patients receiving a single oral 600 mg of gabapentin (Neurontin®, Pfizer) 1 hour prior to surgery constituted the study group, and patients without gabapentin therapy were considered as the control group. Clinical neurologic evaluation of the patients was performed during surgery. The patients' heamodynamic parameters, sedation scores, stress response parameters and postoperative analgesic requirement were evaluated. Results: Hemodynamic parameters in the study group were more stable than those in the control group in spite of less requirement for vasoactive agent support. Patients' sedative scores and cooperation levels were similar in both groups. As one of the stress response parameters, cortisol levels in the control group were statistically significantly higher after clamping the carotid artery and postoperative 24th hour cortisol levels in both groups decreased below baseline values. Postoperative analgesic requirement in the study group was less than the control group. Conclusion: In conclusion, our results have shown that use of gabapentin for regional anesthesia in patients undergoing carotid endarterectomy does not affect patient cooperation and provided stable hemodynamic status with less requirements for vasoactive agents and postoperative analgesics.