Glycopyrrolate and cardiac dysrhythmias in geriatric patients after reversal of neuromuscular blockade.
The increase in cardiac muscarinic activity following injection of anticholinesterases can be minimized by the long-acting anticholinergic drug glycopyrrolate. In a series of 50 patients 65 years of age or older who had received glycopyrrolate (0.88 +/- 0.15 mg) mixed with neostigmine (4.40 +/- 0.66 mg) or pyridostigmine (17.46 +/- 2.92 mg) to antagonize neuromuscular blockade, the incidence of new postoperative cardiac dysrhythmias was 16 per cent. All dysrhythmias occurred in patients with pre-existing cardiovascular disease. There was no statistically significant relationship between the incidence of cardiac dysrhythmias and the choice of anaesthetic technique or anticholinesterase drug.
D000368:Aged; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000517:prevention & control*; D001285:Atropine / Q000494:pharmacology; D002318:Cardiovascular Diseases / Q000150:complications; D002800:Cholinesterase Inhibitors / Q000494:pharmacology; D006024:Glycopyrrolate / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D009388:Neostigmine / Q000037:antagonists & inhibitors*; D011183:Postoperative Complications / Q000517:prevention & control*; D011729:Pyridostigmine Bromide / Q000037:antagonists & inhibitors*; D011759:Pyrrolidines / Q000494:pharmacology*; D013997:Time Factors
D002800:Cholinesterase Inhibitors; D011759:Pyrrolidines; D009388:Neostigmine; D001285:Atropine; D011729:Pyridostigmine Bromide; D006024:Glycopyrrolate