Background and Objectives: Pre-eclampsia is one of the common causes of maternal mortality. A main problem with induction of general anesthesia in these patients is exagergted increase of blood presscure during laryngoscopy and intubation that is associateed with a significantly increased intracranial pressure with the risk of cerebral hemorrhage. There are some strategies to minimize extreme increase in blood pressure during laryngoscopy and intubation. The aim of this study was to evaluate the effect of Fentanyl-Droperidol combination (Talamonal) on reducing cardiovascular responses due to laryngoscopy and intubation in preeclamptic parturient.

 Methods: Thirty preeclamptic parturients who were admitted for emergency caesarean section under general anesthesia were studied. All patients had diastolic pressures sustained at ≥ 100 mmHg, and had received antihypertensive therapy. A standard general anesthesia was induced in all patients. Fentanyl-Droperidol combination was used only in the case group five minutes before induction of anesthesia.

 Results: Arterial pressure and heart rate increases, improved in approximately 86.6 % of the case group. The mean increase in systolic pressure, and heart rate following laryngoscopy and intubation was significantly different in two groups (P=0.0001). There was no significant difference in the mean Apgar score of the neonates at 1 and 5 minutes after delivery in two groups.

 Conclusion: Using Fentanyl-Droperidol Combination during induction of anesthesia produced a clinically significant decrease in sympathetic response to laryngoscopy and intubation in most mothers, without any adverse effect on the neonates.

 Background & Objectives: One of the most common ways in intubation without muscle relaxant is using propofol and remifentanil. The common practice is injection of remifentanil and then propofol. This occasionally produces severe hemodynamic changes. The aim of this study is to inject propofol followed by remifentanil for evaluating the effect of the order of injection on decreasing these complications.

 Methods: 40 patients with American Society of Anesthesia (ASA) class I-II, who underwent minor elective surgery with airway mallampati class I-II entered the study. Patients were randomized into 2 groups each with 20 patients. The first group received 2.5mg/kg propofol followed by 1.5 g/mg remifentanil while the second group received 1.5 g/mg remifentanil followed by 2.5 mg/kg propofol. Laryngoscopy and hemodynamic changes were compared in two groups.

 Resutls: There was no difference between two groups in laryngoscopy attempts (P=0.145) but the frequency of easy laryngoscopy in the first group (85%) was more than the second group (60%) (P=0.031). Systolic blood pressure changes after laryngoscopy in the first group (20 7.7 mmHg) was less than the second group (28 6.7 mmHg) (P=0.001). There was no statistical significant difference between two groups in diastolic blood pressure and heart rate changes (P=0.88, P=0.86 respectively).

 Conclusion: Administrations of propofol before remifentanil during anesthesia induction produces acceptable hemodynamic changes in patients.