title: Preinduction atropine or glycopyrrolate and hemodynamic changes associated with induction and maintenance of anesthesia with propofol and alfentanil.
abstract: Total intravenous anesthesia by infusions of propofol and alfentanil may be associated with decreases in heart rate and blood pressure. The effects of two vagolytic agents on these hemodynamic changes were studied in 24 ASA physical status 1 patients undergoing body surface surgery. Patients were randomly allocated to receive atropine 10 micrograms/kg, glycopyrrolate, 5 micrograms/kg, or 0.9% sodium chloride, intravenously, 5 min before induction of anesthesia with loading doses of alfentanil, 50 micrograms/kg and propofol 1 mg/kg. Anesthesia was maintained with infusions of alfentanil 50 micrograms.kg-1.hr-1, and propofol 10 mg.kg-1.hr-1 for the first 10 min, 8 mg.kg-1.hr-1 for the next 10 min, and 6 mg.kg-1.hr-1 thereafter. Patients given glycopyrrolate before anesthesia had significantly higher arterial pressures than did patients receiving either atropine or saline, even though heart rates increased equally after glycopyrrolate and atropine.
authors.affiliation: Sir Humphry Davy Department of Anaesthesia, Bristol Royal Infirmary, United Kingdom.
authors.forename: M A
authors.initials: MA
authors.lastname: Skues
authors.forename: M J
authors.initials: MJ
authors.lastname: Richards
authors.forename: A P
authors.initials: AP
authors.lastname: Jarvis
authors.forename: C
authors.initials: C
authors.lastname: Prys-Roberts
mesh_terms: D000328:Adult; D015760:Alfentanil; D000762:Anesthesia Recovery Period; D000777:Anesthetics / Q000494:pharmacology*; D001285:Atropine / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects*; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000031:analogs & derivatives* / Q000494:pharmacology; D006024:Glycopyrrolate / Q000494:pharmacology*; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010636:Phenols / Q000494:pharmacology*; D011184:Postoperative Period; D011229:Preanesthetic Medication; D015742:Propofol; D011759:Pyrrolidines / Q000494:pharmacology*; D011897:Random Allocation
chemical_list: D000777:Anesthetics; D010636:Phenols; D011759:Pyrrolidines; D015760:Alfentanil; D001285:Atropine; D005283:Fentanyl; D006024:Glycopyrrolate; D015742:Propofol