Comparison of atropine and glycopyrronium in patients with pre-existing cardiac disease.
The effects of atropine and glycopyrronium, when given intravenously with neostigmine during the reversal of neuromuscular blockade in patients with cardiovascular disease, were compared in a double blind trial. Atropine was associated with a significantly greater elevation of heart rate and rate-pressure product than glycopyrronium. This elevation was also more sustained with atropine. The entire atropine population also showed a significantly greater incidence of ST-segment depression on the electrocardiogram than that observed in those who had received glycopyrronium. Furthermore, patients with ischaemic heart disease and previous myocardial infarction who received atropine showed a significantly greater incidence of dysrhythmias than those given glycopyrronium. It is suggested that at the time of reversal of neuromuscular blockade in patients with cardiovascular disease, glycopyrronium is a more suitable agent than atropine.
D000368:Aged; D001285:Atropine / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects; D003327:Coronary Disease / Q000150:complications; D004311:Double-Blind Method; D004562:Electrocardiography; D005260:Female; D006024:Glycopyrrolate / Q000494:pharmacology*; D006331:Heart Diseases / Q000150:complications*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D009203:Myocardial Infarction / Q000150:complications; D011759:Pyrrolidines / Q000494:pharmacology*; D011897:Random Allocation; D013514:Surgical Procedures, Operative; D013997:Time Factors
D011759:Pyrrolidines; D001285:Atropine; D006024:Glycopyrrolate