الفهرس 
Introduction and Aim of the WorkOnly 14 pages are availabe for public view
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Abstract
Summary and Conclusion
This study has been carried out in El-Minia university hospital from the period of Febraury 2007 to June 2008 on 80 adult patients of both sexs ASA physical status grade I and II undergoing elective surgery under general anesthesia were selected for this prospective double blinded study. The aim of this study is to find the optimum dose of ephedrine which improves tracheal intubation after rocuronium and studying hemodynamics after induction of anesthesia with propofol.
Induction of anesthesia was done using morphine 0.1 mg/kg, propofol 2.5 mg/kg and rocuronium 0.6 mg/kg. Then patients were allocated into four equal groups (20 patients each):
Group(1): received 50 ug/kg ephedrine before rapid tracheal intubation. Group(2): received 100 ug/kg ephedrine before rapid tracheal intubation. Group (3): received 200 ug/kg ephedrine before rapid tracheal intubation. Group (4): received saline (control group) before rapid tracheal intubation. All in the same volume and in identical syringes.
Maintainance of anesthesia was done using isoflurane (1.2%) in 100% oxygen. Incremental doses of rocuronium (0.15 mg/kg) were given to the patient along the time of the operation.
We measured heart rate, systolic and diastolic blood pressure and arterial oxygen saturation were taken before induction (baseline), post induction (before intubation) 1 min after intubation then every 5 minutes till the end of surgery and intubating condition were graded according to the criteria of Cooper which comprise: jaw relaxation, vocal cord position and response to intubation.
Hemodynamic response (heart rate and blood pressure) showed marked increase in ephedrine group especially with ephedrine high dose (200ug/kg). No marked differences were seen between the other two groups of ephedrine (50-100ug/kg). Heart rate and blood pressure showed decrease in saline group.
In this study the results showed significant decrease in the heart rate in control group post induction. While in the ephedrine treated group there was insignificant change in HR and insignificant increase in HR in control group after intubation while in ephedrine treated groups there was significant increase in the heart rate.
A statistically significant differences between the baseline heart rate and the rate 1 min, 5 minutes, 10 min, 15 min, 20 min, 25 min and 30 min after intubation in group (1). And till 35 min after intubation in groups (2) and (3). With no significant differences between the base line value and the other subsequent values in group (4).
As regards to systolic and diastolic blood pressure results showed significant decrease in the systolic & diastolic blood pressures in control group post induction (before intubation). While in the ephedrine treated group there was insignificant change. Insignificant increase in control group after intubation. While in ephedrine treated groups there was significant increase in the both systolic and diastolic blood pressure.
A statistically significant differences between the baseline (systolic & diastolic) blood pressures and the blood pressure 1 min ,5 minutes, 10 min, 15 min, 20 min, 25 min, 30 min and 35 min after intubation in group (1) , till 30 min in group (2) and till 40 min in group (3). With no significant differences between the base line value and the other subsequent values in group (4).
Also in the results of this study we observed that tracheal intubating conditions showed a highly statistically significant difference between group (3) and group (4) ( p-value <0.001) and a mild statistically significant difference between group (1)& (2) and group (4) (p-value<0.05).
From this results we concluded that ephedrine improve tracheal intubation after rocuronium and hemodynamics after induction of anesthesia with propofol.
We recommended the use of ephedrine 100 ug/kg to improve tracheal intubation after rocuronium and hemodynamics after induction of anesthesia with propofol while increasing the dose has harmful hemodynamic effect without more improving on the intubating conditions.