Purpose: The aim of this study was the evaluation of hemodynamic effects of the drugs that are commonly used in anesthesia to evaluate which anesthetic causes fewer changes in smokers.
Design and criteria: 64 smokers patients, with ASA I-II and 18-60 years of age who are undergoing general anesthesia were enrolled. Patients with a history of hypertension, coronary artery disease, seizure, psychiatric disease, liver or kidney disease, drug abuse, hypersensitivity to fentanyl, ketamine, propofol and atracurium are excluded. Methods: Before induction, all patients receive ringer 5 cc/kg. The monitoring of ECG, heart rate, pulse oximetry and noninvasive blood pressure measurement is performed. In first group we inject 1 mg midazolam, 0.5 mg/kg ketamine and 2 mg/kg propofol with rate of 80 mg/kg/h. In second group we administrate 2 microgr/kg fentanyl instead ketamine. After eye reflex loss, atracurium 0.5 mg / kg is injected. After 2-3 min the patients are intubated with endotracheal tube. Anesthesia is maintained with propofol 100 microgr/kg and O2-N2O 50%. Primary outcomes: Vital signs, including systolic blood pressure, diastolic blood pressure and heart rate before induction, before and after intubation and then every 5 minutes until half-an-hour are measured and recorded. Also laryngospasm and bronchospasm are evaluated.