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KMID : 0356920140670010026
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Korean Journal of Anesthesiology
2014 Volume.67 No. 1 p.26 ~ p.31
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The dose effect of ephedrine on the onset time and intubating conditions after cisatracurium administration
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Cha Dong-Guk
Kim Kyo-Sang
Jeong Ji-Seon
Kwon Hye-Mee
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Abstract
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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.
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KEYWORD
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Cisatracurium, Ephedrine, Hemodynamics, Intubation
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