• Eduardo Toshiyuki Moro, Giane Nakamura, Rodolfo Silva de Martino, Márcio Luiz Nakamoto, Geraldo Rolim Rodrigues Júnior, Eliana Marisa Ganem, and Norma Sueli Pinheiro Módolo.
• Hospital das Clínicas da Faculdade de Medicina da UNESP, CEP 18618-970 Botucatu, São Paulo, Brazil.
• Rev Assoc Med Bras. 2007 May 1;53(3):272-5.

ObjectiveThe onset time of neuromuscular blocking drugs is partially determined by circulatory factors, including muscle blood flow and cardiac output. The aim of the present paper was to: 1) compare the haemodynamic effects of adding different doses of ephedrine to an induction dose of propofol and remifentanil. 2) onset time of cisatracurium.MethodsSixty patients were randomly allocated into three groups: G1 - 1% propofol; G2 - 1% propofol + 0.5 mg.ml-1 ephedrine and G3 - 1% propofol + 1.0 mg.ml-1 ephedrine. All patients received continuous infusion of remifentanil (0.5 mg.kg-1.min-1). The rate of propofol infusion was 180 ml.h-1 until loss of consciousness and a loading dose of cisatracurium (0.15 mg.kg-1) was then given. After induction of anesthesia, the ulnar nerve was stimulated supramaximally every 10s, and the evoked twitch response of the adductor pollicis was recorded by accelerometry.ResultsThere was no statistical difference between groups with respect to age, weight, dose of propofol administered and onset time of cisatracurium. Heart rate, SpO2, systolic, diastolic and mean blood pressures were compared at 1 and 3 min post-induction. There were statistical differences in HR, SAP, DAP and MAP, without significant adverse clinical effects.ConclusionsThere were no clinically important decreases in the hemodynamic parameters evaluated in the groups receiving ephedrine or not, and the onset time of cisatracurium was the same for all groups.

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