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Abstract
The time interval between the suppression of protective reflexes by induction of anaesthesia and the development of satisfactory intubating conditions is a dangerous phase of anaesthesia; regurgitation, hypoxia, and tracheo-bronchial aspiration occur most frequently during this period.
It is desirable therefore, that this time interval should be as short as possible. The establishment of neuromuscular blockade usually determines the length of this period. That’s why the concept of rapid sequence induction was developed in clinical practice of anaesthesia.
The search for new muscle relaxants that can replace Succinylcholine never stopped. Rocuronium is a quaternary steroid analogue which produces muscle paralysis by competitive antagonism of the nicotinic cholinergic receptors of the skeletal muscles; it has a fast onset of action (90 seconds), an intermediate duration of action, rapid recovery and shows minimal cumulation.
Rocuronium is the nearest non-depolarizing muscle relaxant to Succinylcholine in terms of fast onset of action, yet it is not as fast as Succinylcholine. And it does not produce good intubating conditions as succinylcholine after 60 seconds but offers successful intubation in less than 90 seconds.
Cisatracurium besilate (besylate) is a nondepolarising neuromuscular blocking agent with an intermediate duration of action. Cisatracurium besilate is not associated with dose-related histamine release and, consistent with this, has demonstrated cardiovascular stability in both healthy patients and those with coronary artery disease. Relative to atracurium besilate, cisatracurium besilate has a lower propensity to cause histamine release is more potent but has a slightly longer onset time at equipotent doses.
The aim of this study was to study the effect of administration of ephedrine prior to rocuronium bromide and