Hypotension and bradycardia in the propofol and alfentanil anesthesia are common during induction and maintenance. Ephedrine has been used to attenuate hypotension and bradycardia in the propofol and alfentanil anesthesia. We designed this study to determine whether propofol and alfentanil anesthesia could affect the blood pressure and heart rate response to intravenous ephedrine when compared with the awake state.

Forty patients of ASA physical status 1 or 2 were assigned to one of two groups (Awake vs Propofol-alfentanil [P-A] group). Each patients received ephedrine 0.15 mg/kg after assessment of baseline hemodynamic values. In the awake patients, ephedrine were administered after hemodynamic parameters are stabilized. If hemodynamic parameters are stabilized after intubation, ephedrine were administered in the propofol-alfentanil anesthesia patients. The changes in systolic/diastolic blood pressure (SBP/DBP), mean blood pressure (MBP), and heart rate (HR) were recorded every one minute for 10 minutes.

Ephedrine increased the heart rate significantly in Awake group but not in P-A group. In the P-A group, 3 min after the administration of ephedrine, MBP increased 25.3%. In Awake group, 2 min after the administration of ephedrine, MBP increased only 6.3%.

We conclude that propofol and alfentanil anesthesia augments the BP response to intravenous ephedrine but not HR.