Hajigholam Saryazdi Hamid, Honarmand Azim, Nazemroaya Behzad, Naderi Afshar Pouyan
Department of Anesthesiology, School of Medicine, Anesthesiology and Critical Care Research Center, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Anesthesiology, School of Medicine, Anesthesiology and Critical Care Research Center, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
Adv Biomed Res. 2023 Jan 27;12:13. doi: 10.4103/abr.abr_398_21. eCollection 2023.
Low-dose ephedrine and ketamine may accelerate the onset time of action of neuromuscular blocking agents. We studied the effect of ephedrine and ketamine and cisatracurium priming on endotracheal intubation conditions and the onset time of action of cisatracurium.
The study was a double-blind clinical trial performed on American Society of Anesthesiologists (ASA) class 1 and 2 patients, who were candidates for general anesthesia. In total, 120 patients were entered into the study and were divided into 4 groups, E, K, E + K, and N. The first group was given 70 mcg/kg ephedrine (E group), the second group was given 0.5 ml/kg ketamine (K group), the third group was given the same amount of ketamine plus ephedrine (E + K group), and the fourth group was given the same volume of normal saline (control group); a single dose of 0.1 mg/kg cisatracurium was given, and intubating conditions were evaluated at 60 seconds after cisatracurium administration.
The mean Cooper score based on the response to laryngoscopy, the position of the vocal cords, and the movement of the diaphragm of patients in the control group with a mean of 2.53 ± 1.07 was significantly lower than in the three groups of E, K, and E + K with the means of 4.47. 1.17, 4.53 ± 1.14, and 7.63 ± 1.42, respectively ( value < 0.001). In the (E + K) group, it was significantly higher than in the two other drugs alone ( value < 0.001). The two groups of E and K alone were not significantly different from each other ( value = 0.997). The means of hemodynamic parameters were not significantly different in any of the groups ( value > 0.05).
According to the results of the present study, the use of low-dose ephedrine and ketamine alone can improve intubation conditions. In addition, the combined use of these drugs not only had any Positive effect on patients' hemodynamic parameters but also greatly improved intubation conditions.
低剂量麻黄碱和氯胺酮可能会加速神经肌肉阻滞剂的起效时间。我们研究了麻黄碱、氯胺酮和顺式阿曲库铵预注对气管插管条件和顺式阿曲库铵起效时间的影响。
本研究是一项对美国麻醉医师协会（ASA）1级和2级患者进行的双盲临床试验，这些患者均为全身麻醉的候选对象。共有120例患者纳入研究并分为4组，即E组、K组、E+K组和N组。第一组给予70μg/kg麻黄碱（E组），第二组给予0.5ml/kg氯胺酮（K组），第三组给予等量氯胺酮加麻黄碱（E+K组），第四组给予等量生理盐水（对照组）；给予单剂量0.1mg/kg顺式阿曲库铵，并在给予顺式阿曲库铵60秒后评估插管条件。
基于喉镜检查反应、声带位置和患者膈肌运动的平均库珀评分，对照组平均为2.53±1.07，显著低于E组、K组和E+K组，这三组的平均值分别为4.47±1.17、4.53±1.14和7.63±1.42（P值<0.001）。在（E+K）组中，该评分显著高于其他两种单独用药组（P值<0.001）。单独使用麻黄碱的E组和单独使用氯胺酮的K组之间无显著差异（P值=0.997）。任何一组的血流动力学参数平均值均无显著差异（P值>0.05）。
根据本研究结果，单独使用低剂量麻黄碱和氯胺酮均可改善插管条件。此外，联合使用这些药物不仅对患者的血流动力学参数没有任何不良影响，还能显著改善插管条件。
