The effect of ephedrine on intubating conditions and haemodynamics during rapid tracheal intubation using propofol and rocuronium.
BACKGROUND
We compared the effect of pre-treatment with ephedrine 75, 100, 150 microg kg(-1) and saline on intubating conditions and haemodynamics during rapid tracheal intubation using propofol and rocuronium.


METHODS
One hundred adult patients randomized into one of the four groups-PE 75, PE 100, PE 150, and saline (control) groups-were pre-treated with i.v. ephedrine 75, 100, 150 microg kg(-1) or saline, respectively, 1 min before rapid tracheal intubation using propofol 2.5 mg kg(-1) and rocuronium 0.6 mg kg(-1). A blinded anaesthesiologist assessed the intubating conditions. Heart rate and mean arterial pressure were recorded before anaesthesia induction (baseline), post-induction, and every minute after intubation for 5 min. A 20% change in haemodynamic variables from baseline was regarded as clinically significant. Data were analysed using anova test with post hoc Tukey's test and chi2 or Fisher's exact test. P < 0.05 was regarded as significant.


RESULTS
Patient characteristics, baseline heart rate, and mean arterial pressure were comparable between the groups. Intubating conditions were significantly better in the PE 75 (P = 0.003) and PE 100 (P = 0.001) groups. A significant increase in heart rate was observed in the PE 75 and PE 150 groups when compared with the saline group. A statistically significant difference in mean arterial pressure was noted between PE 75 and PE 150 groups and between PE 150 and saline groups at most of the time intervals. However, when considering the clinical significance of these, all groups were comparable (P > 0.05).


CONCLUSIONS
Ephedrine either 75 or 100 microg kg(-1) given before rapid tracheal intubation using propofol and rocuronium bromide improves the intubation conditions. It is not effective in preventing the hypotension which follows ensuing induction of anaesthesia.
Gopalakrishna
M D
MD
Department of Anaesthesiology, Kasturba Medical College, Manipal 576104, India.
Krishna
H M
HM
Shenoy
U K
UK
D000293:Adolescent; D000328:Adult; D000732:Androstanols; D000768:Anesthesia, General; D018686:Anesthetics, Intravenous; D001794:Blood Pressure / Q000187:drug effects*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004809:Ephedrine / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007022:Hypotension / Q000517:prevention & control; D007431:Intraoperative Complications / Q000517:prevention & control; D007442:Intubation, Intratracheal / Q000379:methods*; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D003473:Neuromuscular Nondepolarizing Agents; D011292:Premedication / Q000379:methods; D015742:Propofol; D000077123:Rocuronium; D014662:Vasoconstrictor Agents / Q000008:administration & dosage / Q000627:therapeutic use
D000732:Androstanols; D018686:Anesthetics, Intravenous; D003473:Neuromuscular Nondepolarizing Agents; D014662:Vasoconstrictor Agents; D004809:Ephedrine; D000077123:Rocuronium; D015742:Propofol