Oral Amantadine Versus Gabapentin to Attenuate the Response to Laryngoscopy and Tracheal Intubation
Condition: Effect of Laryngoscopy and Tracheal Intubation
Study type: Interventional
Phase: Phase 2/Phase 3

Summary: 
      To evaluate the effect of oral amantadine versus gabapentin premedication on the hemodynamic
      response to laryngoscopy and tracheal intubation and their effect on β-endorphins.
    

Detailed description: 
      Direct laryngoscopy and passage of endotracheal tube through the larynx is a noxious
      stimulus, which can provoke untoward response in the cardiovascular, respiratory and other
      physiological systems. Gabapentin, is 1-aminomethyl cyclohexane acetic acid.Gabapentin is
      structurally related to the neurotransmitter gamma-aminobutyric acid (GABA). Gabapentin act
      in central nervous system CNS), it acts by decreasing the synthesis of neurotransmitter
      glutamate and by binding to the alpha 2 delta subunits of voltage dependent calcium channels.

      Amantadine is a non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist, and compared
      to ketamine, it is well tolerated with fewer side effects (mainly dizziness, sedation, and
      dry mouth). Amantadine's formulation permits the oral route for drug delivery, as well as the
      IV route. The side-effects profile of amantadine via all routes seems not to be harmful in
      appropriate dosages.. Amantadine has been clinically used as an antiviral drug, for dementia,
      and in the treatment of Parkinson's disease and spasticity. It is a non-competitive NMDA
      receptor antagonist, and compared to ketamine, it is well tolerated with fewer side effects
      (mainly dizziness, sedation, and dry mouth). Amantadine's formulation permits the oral route
      for drug delivery, as well as the IV route. The side-effects profile of amantadine via all
      routes seems not to be harmful in appropriate dosages.

      In the central nervous system, beta-endorphins bind mu-opioid receptors and exert their
      primary action at presynaptic nerve terminals. However, instead of inhibiting substance P,
      they exert their analgesic effect by inhibiting the release of GABA, an inhibitory
      neurotransmitter, resulting in excess production of dopamine.

      The investigators designed this study to prove the efficacy of oral amantadine versus
      gabapentin premedication on the hemodynamic response to laryngoscopy and tracheal intubation
      and their effect on β-endorphins.
    

Intervention name(s): oral amantadine sulfate; oral gabapentin; Placebo Oral Tablet
Intervention type(s): Other; Drug; Drug
Intervention description(s): In amantadine group:the patients will receive100 mg oral amantadine sulfate 90 minute prior to the surgery; In gabapentin group: the patients will receive oral 800 mg gabapentin 90 minute prior to the surgery; in control group : the patients will receive Placebo Oral Tablet 90 minute prior to the surgery
Other intervention name(s): infex; gabapentin
Intervention MeSH terms: Amantadine; Gabapentin
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Prevention
Keywords: β-endorphins,laryngoscopy and tracheal intubation