If you wish to respond to a paper or other item already published in the BJA, please go to the abstract/full text version of that item and click on the link "E-Letters: Submit a response to the article".
Electronic Letters to:
|
|
E-letters: Electronic letters published:
-
![[Read E-letter]](/icons/misc/sectionDOWN.gif)
GABAPENTIN PREMEDICATION FOR EMERGENCE AGITATION IN CHILDREN
- Asli DONMEZ, Ebru SALMAN, Demet SULEMANJI, Yasin ALIC, Ibrahim OTGUN (13 April 2008)
|
|
|||
|
Asli DONMEZ Baskent University School of Medicine, Ebru SALMAN, Demet SULEMANJI, Yasin ALIC, Ibrahim OTGUN
Send letter to journal:
|
Editor: We found the review about gabapentin by Kong and Irwin (1) informative. We would like to comment on gabapentin’s effect on delirium with our study that was performed in children. In our clinical experience, children undergoing circumcision are more likely to show agitated behavior on emergence. Gabapentin, an anticonvulsant drug has been used for anxiolytic and analgesic properties in adults. However, to our knowledge, there is no study investigating gabapentin’s effects in children. Therefore, we evaluated the efficacy of gabapentin premedication for prevention of emergence agitation and for postoperative analgesia in children undergoing circumcision. We studied 24 ASA-I children >3 yr of age undergoing circumcision with sevoflurane anaesthesia in a prospective randomized manner. Gabapentin 15 mg/kg dissolved in 10 mL of saline were given to 12 children per oral 1/2 hour prior to surgery. The other 12 child received 10 mL of saline. Sevoflurane was used as the sole anesthetic. Penile block was performed to all patients before surgery. Vital signs, preoperative anxiety scores, time to eye opening, modified Aldrete scores, emergence agitation scores were recorded. All patients’ parents were contacted 24 hr after surgery to evaluate pain, total analgesic consumption at 24 hr, parent satisfaction and side effects. Postoperative pain was assessed with faces scale in all patients. Mean age of the patients were 8.0 and 7.7 years in the gabapentin and control groups respectively. Demographic data, preoperative anxiety scores (2.5±1.2 vs 1.8±0.4), time to eye opening (411.6±177.1 vs 368.5±142.0), Aldrete scores, and emergence agitation scores of the patients were similar in both groups. VAS values were significantly lower in the gabapentin group 30 minutes postoperatively (0.3±0.7 vs 1.3±1.6). The incidence of adverse effects was comparable in the groups. Leung et al (2) investigated the effect of gabapentin on postoperative delirium in 21 patients undergoing spinal surgery and stated that patients receiving gabapentin had less postoperative delirium. However, Kong and Irwin (1) questioned their results and declared that gabapentin’s effect on reducing postoperative delirium needs further investigation. The findings of our study in this small series of patient population demonstrated that preoperative oral gabapentin did not have any significant benefit on emergence agitation, but decreased VAS values 30 minutes postoperatively. Future studies with larger patient series are required to better define the efficacy of gabapentin on emergence agitation in children. References: 1- Kong VKF, Irwin MG. Gabapentin: a multimodal perioperative drug? Br J Anaesth 2007;99:775-86 2- Leung JM, Sands LP, Rico M, et al. Pilot clinical trial of gabapentin to decrease postoeperative delirium in older patients. Neurology 2006;67:1251-3 Corresponding author: Asli DONMEZ, MD Fevzi Cakmak Cad 10 sok No 40. Baskent University School of Medicine, Anaesthesiology Department, 06490 Ankara, Turkey E-mail: aslidonmez@baskent-ank.edu.tr Conflict of Interest:None declared |
|||