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For a patient under any treatment it is very important to maintain a stable cardiovascular system (CVS) under anesthesia. The CVS can be disturbed due to many factors, and one of the factor which can later the hemodynamic system of the patient is laryngoscopy and intubation. Hence the assessment of the variations in the blood pressure (BP) and heart rate (HR) of the patient during laryngoscopy and intubation is very important. Hypertension and Tachycardia as a great disorders causing great problems. Such as cerebral hemorrhagia and myocardial infection, which are occurred during general anesthesia. Laryngoscopy and endotracheal intubation is necessary for airway management prevention of the aspiration of gastric contents. The amount of blood pressure and heart rate is measured in 1, 3, 5 after laryngoscopy and intubation. 70 patients ASA1 with the age of 16-55, undergone elective surgery and a general anesthesia were selected. Some drug pre-medication and induction were the same in rate about all patients. 35 patients are intubated orally and the rest of them nasally. The subjects were chosen among patients who did not have difficult intubation and cardiovascular disorders. Before laryngoscopy and 1, 3, 5 minutes blood pressure and HR measured. According to outcoming results, blood pressure and HR increasing after laryngoscopy in both group (Oral intubation and nasal intubation). The increase of nasotracheal intubation was more than oral one remarkably. The difference would be meaningful according to statistic point (P<0.05). According to research finding the most amount of increase in the blood pressure and HR was related to the laryngoscopy and intubation. These changes can make problems for some cardiovascular patients. So it is suggested that all anesthetists should lessen the probable complication of patients under laryngoscopy a tracheal intubation by monitoring BP and HR.

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Background and Objective: From 1942 when Griffith & Johnson suggested that muscle relaxants are safe drugs for better laryngoscopy & intubation and good for skeletal muscle relaxation during surgery, many of muscle relaxants discovered with different effect, side effect and potency. Some of the muscle relaxants properties include rapid onset, short-acting, fast recovery, stability of hemodynamic, lock of histamine release and etc. Hemodynamic stability is one of the important properties of this drug. In this research we wanted to see effect of Rocuronium, which is an intermediate muscle relaxant on systolic, diastolic BP and HR of patients who is candidate for elective surgery. Patients and Methods: This research is an experimental study. We wanted to see the effects of Rocuronium that is an intermediate muscle relaxant on mean avierial pressure and heart rate of the patient who is coming to the hospital of Iran medical university hospitals for elective orthopedic surgery. The sample size calculated 30 patients. We choose our patients with simple randomized method. All of them were ASA1 and in the age of 20 to 50 years old. The patients didn’t receive any pre-medication until coming to operating room. In the OR they received 7 cc/kg ringer solution and then 70 µg/kg thalamonal was administered intravenously. 5 minute latter their BP and PR was checked, which considered baseline measurement. Induction of anesthesia was with Thiopental 5 mg/kg and Rocuronium 0.9 mg/kg. After 60 sec patients were intubated with direct laryngoscopy. The maintenance of anesthesia for first 10 minutes was with O2 50% and N2O 50% and for continue of anesthesia MR and Opioid depend on need. Results: We analyzed our data with paired to T-test and green house test. Systolic and diastolic blood pressure and heart rate changes was 5% lowest than baseline hemodynamic parameter. Conclusion: With attention to previous studies and observation of hemodynamic changes with muscle relaxants which uses in Iran, this drug (Rocuronium) have good effect on stability of hemodynamic parameters. Beside other properties of Rocuronium include: Rapid onset, lack of histamine release, intermediate acting and etc. We can said this drug is a good and safe muscle relaxant for use during anesthesia and surgery.

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Background & Objective: The deterious effects of pressor response (Tachycardia and hypertension) are not hidden from any personal of anesthesia group. The present study is performed in Chamran Hospital affiliated to the university of medical sciences, Shiraz, with the aim to introduce the most effective, cheapest as well as the easiest method to prevent or reduce the pressor response to direct laryngoscopy and intubation. Materials & Methods: This randomized clinical trial was conducted in Chamran Hospital in Shiraz. 90 patients scheduled for elective surgical fixation of femur or tibia were randomly divided in group A (30 patients), group B (30 patients) and group C (30 patients). In-group A patients were directly sprayed with Lidocaine 10%, hypopharyngealy, after induction of anesthesia and 3 minutes before tracheal intubation. Patients in group B were sprayed with Lidocaine 10% oropharyngealy before induction of anesthesia while the patients, were awake, patients in group C were not sprayed with Lidocaine (Control group). Premedication and drugs used for induction of anesthesia were same in 3 groups. The heart rate, systolic and diastolic blood pressure were recorded in all patients included in the study, before tracheal intubation (Base line) just after tracheal intubation and 3 and 5 minutes after intubation. Results: Spraying Lidocaine oropharyngealy before induction of anesthesia and hypopharyngealy after induction of anesthesia both were effective in controlling the pressor response to laryngoscopy and tracheal intubation, but spraying Lidocaine oropharyngealy before induction of anesthesia is more effective than spraying Lidocaine hypopharyngealy after induction of anesthesia (P<0.05). Conclusion: According to the results of present study, applying Lidocaine spray, oropharyngealy is a simple, very effective as well as cheap method for controlling pressor response to tracheal intubation.