Fast tracheal intubation with adminstration of ephedrine before atracurium

ABSTRACT

The most important duty of anesthesiologist is to maintain a secure airway that in emergency patients by injection of intravenous anesthetic drugs such as nesdonal and succinylcholine, tracheal intubation is performed with a 30-45 second delay. But in cases that succinylcholine is contraindicated, nondepolarizing muscle relaxant like atracurium is injected and tracheal intubation is performed with a 3-5 minute delay. The aim of this study was to compare the effect of atracurium and ephedrine with atracurium alone for shortening the time of tracheal intubation. One hundred patients [ASA class I] were randomly divided into two groups of 50 cases. Induction of anesthesia was performed in both groups with nesdonal and then atracurium with dose 0.6mg/kg was administered in both groups. After premedication in case group, ephedrine with dose 70 micro g/kg was performed. In control group, tracheal intubation was performed 3-5 minutes after injection atracurium. Systolic and diastolic blood pressure and heart rate were measured and recorded at different times and also intubaion condition was recorded and data was compared. The mean age was 26.3 +/- 10 years in case group and 31.4 +/- 10 years in control group. In case group, tracheal intubation was performed in all patients during 2 minutes. After anesthesia induction, systolic and diastolic blood pressure decreased and heart rate increased in both groups, but there was a significant difference after intubation at minute 1 and 5 [p<0.05]. Quality of tracheal intubation was seen in 88% of subjects in case group and 96% of subjects in control group, this difference was not statistically significant. Ephedrine can cause a decrease in the onset time of atracurium and faster intubation without adverse hemodynamic effect