title: The dose effect of ephedrine on the onset time and intubating conditions after cisatracurium administration.
abstract: BACKGROUND
  The aim of this randomized, double-blind, placebo-controlled study was to evaluate dose effects of ephedrine pretreatment on the onset time and intubating conditions after cisatracurium administration.
  
  
  METHODS
  A total of 140 adult patients were randomized into 4 groups to receive either 30 µg/kg ephedrine (Group 30, n = 35), 70 µg/kg ephedrine (Group 70, n = 35), 110 µg/kg ephedrine (Group 110, n = 35), 3 ml normal saline (Group C, n = 35) as pretreatment given 30 s before anesthetic induction. Neuromuscular block was achieved with 0.15 mg/kg cisatracurium, evaluated accelomyographically with train-of-four stimulation. An anesthesiologist blinded to patient grouping assessed the intubating conditions 1.5 min after cisatracurium administration.
  
  
  RESULTS
  An onset time of 70 s was obtained in the ephedrine groups (Group 30: 155.4 ± 44.7 s, Group 70: 152.6 ± 40.3 s, Group 110: 151.2 ± 51.6 s) compared to Group C (224.6 ± 56.9 s) after 0.15 mg/kg of cisatracurium (P < 0.001). Ephedrine doses of either 70 or 110 µg/kg for pretreatment significantly improved intubating conditions (P < 0.05). Systolic and diastolic blood pressure and heart rate at 1 min after tracheal intubation were significantly increased than other times in all groups (P < 0.001), with no differences among the groups. However, 5 patients in Group 110 experienced marked hypertension (systolic/diastolic blood pressure: > 200/100 mmHg) 1 min after tracheal intubation with no patients in other groups.
  
  
  CONCLUSIONS
  We conclude that pre-treatment with ephedrine 70 µg/kg improved intubating conditions 1.5 min after cisatracurium administration and facilitated the onset of neuromuscular block (70 s) without adverse hemodynamic effects.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Dong Guk
authors.initials: DG
authors.lastname: Cha
authors.affiliation: Department of Anesthesiology and Pain Medicine, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Kyo Sang
authors.initials: KS
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Ji Seon
authors.initials: JS
authors.lastname: Jeong
authors.affiliation: Department of Anesthesiology and Pain Medicine, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Hye Mee
authors.initials: HM
authors.lastname: Kwon
keywords: Cisatracurium; Ephedrine; Hemodynamics; Intubation
references.citation: Anesthesiology. 2001 Aug;95(2):403-7
references.pmid: 11506113
references.citation: Acta Anaesthesiol Scand. 1986 Jul;30(5):347-50
references.pmid: 2876574
references.citation: J Clin Anesth. 2010 Sep;22(6):425-31
references.pmid: 20868963
references.citation: Anesth Analg. 1997 Mar;84(3):623-8
references.pmid: 9052314
references.citation: Acta Anaesthesiol Scand. 2007 Aug;51(7):789-808
references.pmid: 17635389
references.citation: Anaesth Intensive Care. 1999 Oct;27(5):477-80
references.pmid: 10520387
references.citation: Crit Care Clin. 2000 Jul;16(3):411-27
references.pmid: 10941581
references.citation: Acta Anaesthesiol Belg. 2000;51(3):167-71
references.pmid: 11129616
references.citation: Anaesthesia. 1995 Apr;50(4):361-2
references.pmid: 7747860
references.citation: J Clin Anesth. 1999 May;11(3):220-5
references.pmid: 10434218
references.citation: Anesth Analg. 2003 Apr;96(4):1042-1046
references.pmid: 12651656
references.citation: Anesthesiology. 1995 May;82(5):1131-8
references.pmid: 7537945
references.citation: Anaesthesia. 1996 May;51(5):488-91
references.pmid: 8694167
references.citation: J Clin Anesth. 1999 Nov;11(7):572-5
references.pmid: 10624642
references.citation: Korean J Anesthesiol. 2012 Jun;62(6):518-23
references.pmid: 22778886
references.citation: Br J Anaesth. 1999 Sep;83(3):483-4
references.pmid: 10655927
references.citation: Korean J Anesthesiol. 2012 Oct;63(4):308-13
references.pmid: 23115682
references.citation: Rev Bras Anestesiol. 2003 Feb;53(1):9-16
references.pmid: 19475252