[Effect of ephedrine on the intubation conditions using rocuronium versus succinylcholine]

Abstract

Objective: The goal of this study was to determine if ephedrine could improve intubating conditions when it is administered before the muscle relaxant (rocuronium and succinylcholine).

Patients and methods: In this prospective randomized double-blind study, 80 patients ASA I- II, scheduled for elective surgery, were allocated randomly to receive: succinylcholine 1mg/kg+ephedrine 70 microg/kg (Group I, n=20); rocuronium 0.6 mg/kg+ephedrine 70 microg/kg (Group II, n=20); succinylcholine 1mg/kg+0.9% saline (Group III, n=20); rocuronium 0.6 mg/kg+0.9% saline (Group IV, n=20). Induction of anaesthesia started with administration of the first syringe containing either ephedrine or saline, then 30s later propofol 2.5mg/kg and fentanyl 3 microg/kg, were administered followed by the contents of the second syringe containing either rocuronium or succinylcholine. Thirty seconds after injection of the muscle relaxant, another blinded staff anaesthetist performed intubation of the patient. Intubating conditions were evaluated according to criteria's of the conference of Copenhagen. Heart rate, systolic blood pressure and diastolic were also noted. Kruskall-Wallis test for non-parametric variable and Student t test for quantitative variables were used for statistical analysis.

Results: There was no significant difference between the groups concerning age, sex, BMI and ASA status. Pretreatment by ephedrine improved significantly (p<0.0001) intubating conditions after succinylcholine and rocuronium.

Conclusion: Use of ephedrine 30 seconds before induction with propofol, fentanyl followed by rocuronium or succinylcholine provides faster good conditions of intubation.