title: The influence of induction technique on intubating conditions 1 min after rocuronium administration: a comparison of a propofol-ephedrine combination and propofol.
abstract: We conducted a double blind, prospective, controlled trial comparing intubating conditions after induction with a propofol-ephedrine combination or propofol alone, followed by rocuronium. One hundred adult patients were randomly assigned to receive either propofol 2.5 mg x kg(-1) and ephedrine 15 mg in combination or propofol 2.5 mg x kg(-1) given over 30 s, followed by rocuronium 0.6 mg x kg(-1) given over 5 s. Tracheal intubation was performed 1 min later. Jaw relaxation, vocal cord position and diaphragmatic response were used to assess intubation conditions. Tracheal intubation was successful and acceptable in all patients. There was a significantly higher proportion of intubating conditions graded as 'excellent' in the propofol-ephedrine group (84%) than in the propofol group (32%) (p < 0.0001). Vocal cord position and response to intubation were significantly better in the propofol-ephedrine group, although jaw relaxation was similar. Mean arterial pressure was maintained at pre-induction levels in the propofol-ephedrine group. In conclusion, induction with propofol and ephedrine in combination provided significantly better intubating conditions than propofol alone, when followed by rocuronium.
authors.affiliation: Department of Anaesthesia, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong SAR. chinhow@netvigator.com
authors.forename: C H
authors.initials: CH
authors.lastname: Tan
authors.forename: M K
authors.initials: MK
authors.lastname: Onisong
authors.forename: W K Y
authors.initials: WK
authors.lastname: Chiu
mesh_terms: D000328:Adult; D000732:Androstanols / Q000494:pharmacology; D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects; D003964:Diaphragm / Q000187:drug effects; D004311:Double-Blind Method; D004338:Drug Combinations; D004809:Ephedrine / Q000494:pharmacology*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D007568:Jaw / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D009126:Muscle Relaxation / Q000187:drug effects; D009469:Neuromuscular Junction / Q000187:drug effects; D003473:Neuromuscular Nondepolarizing Agents / Q000494:pharmacology; D015742:Propofol / Q000494:pharmacology*; D011446:Prospective Studies; D000077123:Rocuronium; D013566:Sympathomimetics / Q000494:pharmacology*; D014827:Vocal Cords / Q000187:drug effects
chemical_list: D000732:Androstanols; D018686:Anesthetics, Intravenous; D004338:Drug Combinations; D003473:Neuromuscular Nondepolarizing Agents; D013566:Sympathomimetics; D004809:Ephedrine; D000077123:Rocuronium; D015742:Propofol