Gopalakrishna M D, Krishna H M, Shenoy U K
Department of Anaesthesiology, Kasturba Medical College, Manipal 576104, India.
Br J Anaesth. 2007 Aug;99(2):191-4. doi: 10.1093/bja/aem125. Epub 2007 May 16.
We compared the effect of pre-treatment with ephedrine 75, 100, 150 microg kg(-1) and saline on intubating conditions and haemodynamics during rapid tracheal intubation using propofol and rocuronium.
One hundred adult patients randomized into one of the four groups-PE 75, PE 100, PE 150, and saline (control) groups-were pre-treated with i.v. ephedrine 75, 100, 150 microg kg(-1) or saline, respectively, 1 min before rapid tracheal intubation using propofol 2.5 mg kg(-1) and rocuronium 0.6 mg kg(-1). A blinded anaesthesiologist assessed the intubating conditions. Heart rate and mean arterial pressure were recorded before anaesthesia induction (baseline), post-induction, and every minute after intubation for 5 min. A 20% change in haemodynamic variables from baseline was regarded as clinically significant. Data were analysed using anova test with post hoc Tukey's test and chi2 or Fisher's exact test. P < 0.05 was regarded as significant.
Patient characteristics, baseline heart rate, and mean arterial pressure were comparable between the groups. Intubating conditions were significantly better in the PE 75 (P = 0.003) and PE 100 (P = 0.001) groups. A significant increase in heart rate was observed in the PE 75 and PE 150 groups when compared with the saline group. A statistically significant difference in mean arterial pressure was noted between PE 75 and PE 150 groups and between PE 150 and saline groups at most of the time intervals. However, when considering the clinical significance of these, all groups were comparable (P > 0.05).
Ephedrine either 75 or 100 microg kg(-1) given before rapid tracheal intubation using propofol and rocuronium bromide improves the intubation conditions. It is not effective in preventing the hypotension which follows ensuing induction of anaesthesia.
我们比较了麻黄碱75、100、150微克/千克以及生理盐水预处理对使用丙泊酚和罗库溴铵进行快速气管插管时的插管条件和血流动力学的影响。
100例成年患者被随机分为四组——PE 75组、PE 100组、PE 150组和生理盐水（对照组）组——分别在使用2.5毫克/千克丙泊酚和0.6毫克/千克罗库溴铵进行快速气管插管前1分钟静脉注射75、100、150微克/千克麻黄碱或生理盐水。一位不知情的麻醉医生评估插管条件。在麻醉诱导前（基线）、诱导后以及插管后5分钟内每分钟记录心率和平均动脉压。血流动力学变量相对于基线变化20%被视为具有临床意义。数据采用方差分析及事后Tukey检验以及卡方检验或Fisher精确检验进行分析。P<0.05被视为具有显著性。
各组患者的特征、基线心率和平均动脉压具有可比性。PE 75组（P = 0.003）和PE 100组（P = 0.001）的插管条件明显更好。与生理盐水组相比，PE 75组和PE 150组观察到心率显著增加。在大多数时间间隔内，PE 75组和PE 150组之间以及PE 150组和生理盐水组之间的平均动脉压存在统计学显著差异。然而，考虑到这些差异的临床意义，所有组均具有可比性（P>0.05）。
在使用丙泊酚和溴化罗库溴铵进行快速气管插管前给予75或100微克/千克麻黄碱可改善插管条件。它在预防随后麻醉诱导引起的低血压方面无效。
