RESUMO
This study aimed to compare the impact of adding a small dose ephedrine versus priming technique, with a bolus dose, on the onset time, recovery index and clinical duration of cisatracurium. Also, the intubating conditions and hemodynamic changes were evaluated. Forty-five patients were randomly assigned and allocated into three groups of 15 patients each. Induction was achieved in all three groups by fentanyl 1-2 mug/kg and propofol 2 mg/kg. Patients in group A received a bolus dose of 100 mug/kg cisatracurium after induction. Patients in group B were given ephedrine [70 pg/kg] 5 seconds before induction, then 100 mug/kg cisatracurium. Patients in group C were given priming dose 15 mug/kg cisatracurium before induction, followed by 8.5 mug/kg 4 minutes after priming dose. Maintenance was done by NO2/O2, halothane. Neuro-muscular blockade was monitored using TOF- Guard [Organon-Teknika] by recording the acceleration of the thumb resulting from supramaximal stimulation of ulnar nerve at 2 Hz for 2 seconds at 10-second intervals. Anesthesia was induced by fentanyl and propofol and then maintained by 0.870 halothane in fresh gas flow [66% N20 in 33% 02]. In conclusion, both techniques, priming and small dose ephedrine, produced significant reduction in onset time of cisatracurium as compared to using bolus dose. This was more eminent in the priming group, there was a significant prolongation of clinical duration as well and was void of adverse hemodynamic effects