[Effect of propofol in combination with ephedrine upon the onset time of cisatracurium].
OBJECTIVE
The onset time of neuromuscular blocking drugs is partially determined by circulatory factors, including muscle blood flow and cardiac output. The aim of the present paper was to: 1) compare the haemodynamic effects of adding different doses of ephedrine to an induction dose of propofol and remifentanil. 2) onset time of cisatracurium.


METHODS
Sixty patients were randomly allocated into three groups: G1 - 1% propofol; G2 - 1% propofol + 0.5 mg.ml-1 ephedrine and G3 - 1% propofol + 1.0 mg.ml-1 ephedrine. All patients received continuous infusion of remifentanil (0.5 mg.kg-1.min-1). The rate of propofol infusion was 180 ml.h-1 until loss of consciousness and a loading dose of cisatracurium (0.15 mg.kg-1) was then given. After induction of anesthesia, the ulnar nerve was stimulated supramaximally every 10s, and the evoked twitch response of the adductor pollicis was recorded by accelerometry.


RESULTS
There was no statistical difference between groups with respect to age, weight, dose of propofol administered and onset time of cisatracurium. Heart rate, SpO2, systolic, diastolic and mean blood pressures were compared at 1 and 3 min post-induction. There were statistical differences in HR, SAP, DAP and MAP, without significant adverse clinical effects.


CONCLUSIONS
There were no clinically important decreases in the hemodynamic parameters evaluated in the groups receiving ephedrine or not, and the onset time of cisatracurium was the same for all groups.
Hospital das Clínicas da Faculdade de Medicina da UNESP, CEP 18618-970 Botucatu, São Paulo, Brazil.
Eduardo Toshiyuki
ET
Moro
Giane
G
Nakamura
Rodolfo Silva de
RS
Martino
Márcio Luiz
ML
Nakamoto
Geraldo Rolim
GR
Rodrigues Júnior
Eliana Marisa
EM
Ganem
Norma Sueli Pinheiro
NS
Módolo
D000293:Adolescent; D018663:Adrenergic Agents / Q000627:therapeutic use*; D000328:Adult; D000768:Anesthesia, General; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000009:adverse effects*; D001279:Atracurium / Q000031:analogs & derivatives* / Q000494:pharmacology; D001794:Blood Pressure / Q000187:drug effects; D004809:Ephedrine / Q000627:therapeutic use*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007022:Hypotension / Q000139:chemically induced / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009466:Neuromuscular Blocking Agents / Q000494:pharmacology*; D010880:Piperidines / Q000008:administration & dosage / Q000009:adverse effects; D015742:Propofol / Q000008:administration & dosage / Q000009:adverse effects; D000077208:Remifentanil; D013997:Time Factors; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
D018663:Adrenergic Agents; D018686:Anesthetics, Intravenous; D009466:Neuromuscular Blocking Agents; D010880:Piperidines; D014662:Vasoconstrictor Agents; D001279:Atracurium; D004809:Ephedrine; D000077208:Remifentanil; C101584:cisatracurium; D015742:Propofol