Material and method
cardiac, renal, or endocrine disorders, trauma
WEST, RSI, RECRUITMENT, MAY
Imam Reza General Hospital, a trauma referral hospital in Tabriz, East Azarbaijan Province, North West Iran, hosted this clinical trial.Based on our center admission rate, we estimated that we would have 60 eligible patients to enroll in this trial in a six-month period of time (one eligible patient every three days). Patients with a history of trauma who needed airway management with RSI were divided into two groups randomly. Totally, sixty patients entered the study. Randomization was done by using a random number table. Patients under the age of 18, pregnant women, people with a history of cardiac, renal, or endocrine disorders, and people who have taken corticosteroid medication in the past were all excluded. In all patients, a blood sample for serum cortisol level was obtained prior to RSI. In group I, patients underwent RSI with 0.3 mg/kg Etomidate (Aburaihan Pharmaceutical Co., Iran) and 1.5 mg/kg succinylcholine (Chandra Bhagat Pharma Limited, India), and three hours later, serum cortisol levels were checked in these patients. As a placebo, these patients received 10 CC of normal saline (two shots of five CC of saline) intravenously. In group II, one-gram (500 mg/5 cc in two boluses) of intravenous vitamin C (Sobhan Darou Pharmaceutical Co., Iran) was injected in the pretreatment step of RSI, and then patients underwent RSI with Etomidate and succinylcholine. Serum cortisol levels were checked three hours later. All patients received fentanyl (1 micg/kg) and midazolam (0.02 mg/kg) for pretreatment. Patient recruitment began on May 30, 2019. Figure 
Flow chart of the studyThe data was analyzed using SPSS Ver 22 software. The results were reported as frequency (percentage) and median (interquartile range). To determine the normality of data distribution, the Kolmogorov-Smirnov test was used. To analyze the data, other methods of inferential statistics were used, such as the Chi-square test, Mann-Whitney U test, and Wilcoxon signed rank (due to the non-normal nature of the data). P < 0.05 was considered as the level of statistical significance. This study was approved by the ethical committee of Tabriz University of Medical Sciences under the number IR.TBZMED.REC.1397.925. Protocol of this clinical trial was submitted in Iranian registry of clinical trials under the ID of IRCT20090923002496N11.