title: Effect of ephedrine on intubating conditions created by propofol and rocuronium: a meta-analysis.
abstract: OBJECTIVE
  To evaluate the effect of ephedrine on intubation conditions (ICs) one minute after anesthesia induction using propofol and rocuronium.
  
  
  METHODS
  PubMed, EMbase, The Cochrane Library, ISI Web of Knowledge, Chinese Biomedical Literature Database, Google Scholar, and other databases were searched from inception to September 2012 to collect relevant randomized clinical trials (RCTs). We evaluated the risk of bias of the included studies by the Cochrane Collaboration's risk of bias tool and analyzed the data using RevMan 5.1. As the outcomes, excellent ICs, clinically acceptable ICs and side effects were evaluated with risk ratios (RRs).
  
  
  RESULTS
  Five RCTs involving 396 patients were identified. The results of the meta-analysis demonstrated that ephedrine increased the rate of excellent ICs (RR = 2.40, 95% CI 1.89 to 3.05), but had no effects on the rate of clinically acceptable ICs (RR = 1.15, 95% CI 0.93 to 1.42) and the incidence of side effects (RR = 2.00, 95% CI 0.19 to 21.36). Besides, the results of subgroup analysis showed that both low dose and high dose of ephedrine increased the rate of excellent ICs, but only low dose increased the rate of clinically acceptable ICs. The results of sensitive analysis showed that both favored ephedrine (excellent ICs: RR = 2.54, 95% CI 1.69 to 3.83; clinically acceptable ICs: RR = 1.21, 95% CI 1.07 to 1.38).
  
  
  CONCLUSIONS
  Ephedrine, without extra side effects, created superior ICs one minute after anesthesia induction using propofol and rocuronium, and low dose (i.e., 70-100 μg/kg) is recommended as the possible optimal dose.
authors.affiliation: Evidence Based Medicine Centre, School of Basic Medicine Sciences, Lanzhou University, Lanzhou, Gansu, China.
authors.forename: Rao
authors.initials: R
authors.lastname: Sun
authors.forename: Jin Hui
authors.initials: JH
authors.lastname: Tian
authors.forename: Lun
authors.initials: L
authors.lastname: Li
authors.forename: Hong Liang
authors.initials: HL
authors.lastname: Tian
authors.forename: Wen Qin
authors.initials: WQ
authors.lastname: Jia
authors.forename: Ke Hu
authors.initials: KH
authors.lastname: Yang
authors.forename: Nong
authors.initials: N
authors.lastname: Cao
mesh_terms: D018663:Adrenergic Agents / Q000008:administration & dosage*; D000732:Androstanols / Q000008:administration & dosage*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004809:Ephedrine / Q000008:administration & dosage*; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D015233:Models, Statistical; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage*; D017063:Outcome Assessment, Health Care; D015742:Propofol / Q000008:administration & dosage*; D016032:Randomized Controlled Trials as Topic; D000077123:Rocuronium
chemical_list: D018663:Adrenergic Agents; D000732:Androstanols; D018686:Anesthetics, Intravenous; D003473:Neuromuscular Nondepolarizing Agents; D004809:Ephedrine; D000077123:Rocuronium; D015742:Propofol