- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03172234
Oral Amantadine Versus Gabapentin to Attenuate the Response to Laryngoscopy and Tracheal Intubation (15/5/2017)
Oral Amantadine Versus Gabapentin to Attenuate the Hemodynamic Response to Laryngoscopy and Tracheal Intubation and Their Effect on β-endorphin
Study Overview
Status
Intervention / Treatment
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.
Study Type
Enrollment (Actual)
Phase
- Phase 2
- Phase 3
Contacts and Locations
Study Locations
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Assiut, Egypt
- Assiut university hospitals
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- ASA I&II scheduled for elective spine surgery
Exclusion Criteria:
- Patient refusal
- Patients with ASA score III (with chronic kidney, lungs, Gastrointestinal tract, liver, or cardiovascular diseases)
- Pregnant or breastfeeding women.
- Allergy to any of the study medications and taking medications that could significantly interact with amantadine (tramadol, atropine, antipsychotic medications)
- diabetes mellitus, thyroid disease any endocrine disease
- Suspected difficult intubation or intubation time more than 30 second.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Active Comparator: amantadine group (Group A)
the patients will receive oral amantadine sulfate using the dose 100 mg 120 minutes prior to the surgery, 5 ml saline IV 5 minutes before intubation.
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In amantadine group:the patients will receive100 mg oral amantadine sulfate 90 minute prior to the surgery
Other Names:
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Active Comparator: gabapentin group(Group B)
the patients will receive oral gabapentin using the dose 800 mg 120 minutes prior to surgery,5 ml saline IV 5 minutes before intubation.
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In gabapentin group: the patients will receive oral 800 mg gabapentin 90 minute prior to the surgery
Other Names:
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Placebo Comparator: control group (group C)
the patients will receive placebo oral tablet 120 minutes prior to surgery, IV fentanyl 2µ/kg in 5 ml saline 5 minutes before intubation.
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in control group : the patients will receive Placebo Oral Tablet 90 minute prior to the surgery
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
effect of oral amantadine versus gabapentin premedication on laryngoscopy and tracheal intubation on β-endorphins.
Time Frame: baseline blood sample taken before drug administration and after 15 minutes after intubation and before skin incision
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analysis of change of β-endorphins in blood sample
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baseline blood sample taken before drug administration and after 15 minutes after intubation and before skin incision
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
effect of oral amantadine versus gabapentin premedication on the Mean arterial blood pressure due to laryngoscopy and tracheal intubation
Time Frame: baselineMAP before drug administration and after 15 minutes after intubation and before skin incision
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change of Mean arterial blood pressure
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baselineMAP before drug administration and after 15 minutes after intubation and before skin incision
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effect of oral amantadine versus gabapentin premedication on the heart rate due to laryngoscopy and tracheal intubation
Time Frame: baseline heart rate before drug administration and after 15 minutes after intubation and before skin incision
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change of heart rate
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baseline heart rate before drug administration and after 15 minutes after intubation and before skin incision
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Abualauon Elpiplaoy, MD, Assiut University
- Study Chair: Ahmed El shanawany, MD, Assiut University
- Principal Investigator: Azza Abo Elfadl El Sayed, MD, Assiut University
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Anti-Infective Agents
- Central Nervous System Depressants
- Peripheral Nervous System Agents
- Antiviral Agents
- Analgesics
- Sensory System Agents
- Excitatory Amino Acid Antagonists
- Excitatory Amino Acid Agents
- Analgesics, Non-Narcotic
- Tranquilizing Agents
- Psychotropic Drugs
- Dopamine Agents
- Anti-Anxiety Agents
- Anticonvulsants
- Antimanic Agents
- Antiparkinson Agents
- Anti-Dyskinesia Agents
- Gabapentin
- Amantadine
Other Study ID Numbers
- Assuit universty
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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