The Effect of Ephedrine on the Onset Time of Rocuronium
in Thai Patients
WICHAI ITTICHAIKULTHOL, MD*, SURIRAT SRISWA SDI, MD*,
SUPAWADEE NUAL-ON, MD*, SOMPAWUN HONGPUANG,MD*,
ASNEE SORNIL, BSc*
Affiliation : *
Department of Anesthesiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400,
Thailand.
AbstractThe aim of this study was to determine the effect of ephedrine on the onset time of rocuro
nium. The study population was 60 ASA physical status 1 and 2 patients, aged 15-60 years scheduled
for elective surgery under general anesthesia at Ramathibodi Hospital. The patients were randomly
assigned into 2 groups. Group I (ephedrine group), ephedrine 70 f.!g/kg was given 1 minute before
induction and group II (control group), saline was given instead of ephedrine and midazolam 7.5 mg
was given orally 30-60 minutes before the induction. Anesthesia was induced with fentanyl 1 f..lg/kg
and sodium thiopentone 3-5 mglkg. The patient was intubated with 0.9 mglkg of rocuronium. The
intubation time (from rocuronium administration to the time of intubation) was predetermined by the
Dixon's up and down method (with 5 seconds as a step size) for each patient and started at 60 seconds
for the first patient in each group. The intubation time in the ephedrine group (39.41 ± 4.64 seconds)
was significantly different from the control group (59.17 ± 9.00 seconds); p-value < 0.01. The hemo
dynamics were similar in both groups.
Conclusion : Intravenous ephedrine shortened the onset time of rocuronium with no signifi
cant adverse hemodynamic effects. As an alternative to suxamethonium for rapid intubation, the authors
recommend the use of ephedrine 70 f..lg/kg at one minute before induction followed by 0.9 mg/kg of
rocuronium intravenously in healthy patients. The intubation could be achieved at 40 seconds after the
administration.
Keywords : Intubation Time, Rocuronium, Ephedrine
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