Effects Of Addition Of Ephedrine HCl 75 Μg/kg BW IV On The Start Of The Work Of Atracurium Besylate 0.5 Mg/kg BW IV Priming Technique Compared To Rocuronium Bromide 1 Mg/kg BW IV In General Anesthesia Is Endotracheal Intubation

Feb 27, 2025 by ADMIN 228 views

Background and Importance of the Study

Atracurium is a widely used non-depolarizing muscle relaxant in general anesthesia, but it has a relatively slow onset time, which can be a significant obstacle in the process of endotracheal intubation. Rocuronium, on the other hand, has a faster onset time, but its availability in some healthcare facilities may be limited. Therefore, this study aims to investigate the effectiveness of adding Ephedrine HCl 75 μg/kg BW IV to the priming technique of Atracurium Besylate 0.5 mg/kg BW IV in accelerating the onset time of muscle relaxation in general anesthesia.

Methodology and Participants

This study is a double-blinded clinical trial involving 42 participants aged 21-60 years, with ASA 1 and 2 scores, and a body mass index of 18.5-28 kg/m2. All participants underwent elective surgery with general anesthesia endotracheal intubation at H. Adam Malik Hospital Medan. The participants were randomly divided into two groups:

Group 1: Atracurium Priming Technique with Ephedrine HCl 75 μg/kg BW IV

Participants received Ephedrine HCl 75 μg/kg BW IV IV before the administration of Atracurium Besylate 0.5 mg/kg BW IV.
The time of onset of muscle relaxation was measured using Tof-Watch to the TOF value <2.

Group 2: Rocuronium 1 mg/kg BW IV as a Control Group

Participants received Rocuronium 1 mg/kg BW IV as a control group.
The time of onset of muscle relaxation was measured using Tof-Watch to the TOF value <2.

Both groups received fentanyl 2 μg/kg BW IV and propofol 2 mg/kg BW IV as an induction of anesthesia. The data was analyzed using statistical software, 95% confidence interval, and the results were considered significant if the P value was <0.05.

Results and Comparison

The average time of onset of muscle relaxation in the Atracurium priming technique with Ephedrine HCl 75 μg/kg BW IV group was 74.33 seconds (SD 14.94), while the Rocuronium group was 61.95 seconds (SD 24.48), with a value of P = 0.097. Although the difference was not statistically significant, the results suggest that the addition of Ephedrine HCl 75 μg/kg BW IV can accelerate the onset time of Atracurium Besylate 0.5 mg/kg BW IV priming technique.

Conclusion and Implications

The addition of Ephedrine HCl 75 μg/kg BW IV can be a useful alternative to accelerate the onset time of Atracurium Besylate 0.5 mg/kg BW IV priming technique in situations where Rocuronium is not available. However, the time of onset of muscle relaxation with Ephedrine HCl 75 μg/kg BW IV remains slower compared to Rocuronium 1 mg/kg BW IV, although the difference is not statistically significant. Further research with a larger sample and a more comprehensive approach is needed to confirm this result and understand the mechanism of action of Ephedrine HCl 75 μg/kg BW IV in accelerating the onset time of Atracurium Besylate 0.5 mg/kg BW IV priming technique.

Limitations and Future Directions

This study has several limitations, including a relatively small sample size and lack of analysis of the mechanism of action of Ephedrine HCl 75 μg/kg BW IV in accelerating the onset time of Atracurium Besylate 0.5 mg/kg BW IV priming technique. Further research with a larger sample and a more comprehensive approach is needed to confirm this result and understand the mechanism of action of Ephedrine HCl 75 μg/kg BW IV in more detail.

Clinical Implications and Recommendations

This study highlights the potential of Ephedrine HCl 75 μg/kg BW IV as an alternative to accelerate the onset time of Atracurium Besylate 0.5 mg/kg BW IV priming technique in situations where Rocuronium is not available. However, it is essential to consult with qualified medical professionals to determine the right treatment strategy based on the patient's condition and the availability of drugs.

Future Research Directions

Future research should focus on:

Investigating the mechanism of action of Ephedrine HCl 75 μg/kg BW IV in accelerating the onset time of Atracurium Besylate 0.5 mg/kg BW IV priming technique.
Conducting a larger-scale study to confirm the results of this study.
Comparing the efficacy and safety of Ephedrine HCl 75 μg/kg BW IV with other alternatives, such as Rocuronium and other muscle relaxants.

By understanding the effects of Ephedrine HCl 75 μg/kg BW IV on the onset time of Atracurium Besylate 0.5 mg/kg BW IV priming technique, anesthesiologists can make informed decisions about the best treatment strategy for their patients.

Frequently Asked Questions

Q: What is the purpose of this study?

A: The purpose of this study is to investigate the effectiveness of adding Ephedrine HCl 75 μg/kg BW IV to the priming technique of Atracurium Besylate 0.5 mg/kg BW IV in accelerating the onset time of muscle relaxation in general anesthesia.

Q: What are the limitations of this study?

A: This study has several limitations, including a relatively small sample size and lack of analysis of the mechanism of action of Ephedrine HCl 75 μg/kg BW IV in accelerating the onset time of Atracurium Besylate 0.5 mg/kg BW IV priming technique.

Q: What are the implications of this study?

A: The results of this study suggest that the addition of Ephedrine HCl 75 μg/kg BW IV can accelerate the onset time of Atracurium Besylate 0.5 mg/kg BW IV priming technique, although the time of onset remains slower compared to Rocuronium 1 mg/kg BW IV.

Q: What are the potential benefits of using Ephedrine HCl 75 μg/kg BW IV in general anesthesia?

A: The potential benefits of using Ephedrine HCl 75 μg/kg BW IV in general anesthesia include accelerating the onset time of muscle relaxation, reducing the risk of respiratory complications, and improving patient outcomes.

Q: What are the potential risks and side effects of using Ephedrine HCl 75 μg/kg BW IV in general anesthesia?

A: The potential risks and side effects of using Ephedrine HCl 75 μg/kg BW IV in general anesthesia include hypertension, tachycardia, and arrhythmias. However, these risks can be minimized by careful patient selection and monitoring.

Q: What are the next steps in research on Ephedrine HCl 75 μg/kg BW IV in general anesthesia?

A: Future research should focus on investigating the mechanism of action of Ephedrine HCl 75 μg/kg BW IV in accelerating the onset time of Atracurium Besylate 0.5 mg/kg BW IV priming technique, conducting a larger-scale study to confirm the results of this study, and comparing the efficacy and safety of Ephedrine HCl 75 μg/kg BW IV with other alternatives.

Q: How can anesthesiologists apply the findings of this study to their practice?

A: Anesthesiologists can apply the findings of this study by considering the use of Ephedrine HCl 75 μg/kg BW IV as an alternative to accelerate the onset time of Atracurium Besylate 0.5 mg/kg BW IV priming technique in situations where Rocuronium is not available. However, it is essential to consult with qualified medical professionals to determine the right treatment strategy based on the patient's condition and the availability of drugs.

Q: What are the potential applications of this study in other fields of medicine?

A: The findings of this study may have implications for other fields of medicine, such as emergency medicine, critical care, and pain management. Further research is needed to explore the potential applications of Ephedrine HCl 75 μg/kg BW IV in these fields.

Q: How can patients benefit from the findings of this study?

A: Patients can benefit from the findings of this study by receiving more effective and efficient anesthesia care, reducing the risk of respiratory complications, and improving patient outcomes.

Q: What are the potential future directions for research on Ephedrine HCl 75 μg/kg BW IV in general anesthesia?

Q: How can healthcare providers stay up-to-date with the latest research on Ephedrine HCl 75 μg/kg BW IV in general anesthesia?

A: Healthcare providers can stay up-to-date with the latest research on Ephedrine HCl 75 μg/kg BW IV in general anesthesia by attending conferences, reading scientific journals, and participating in online forums and discussions.