title: Different doses of atropine on heart rate fluctuations during reversal of neuromuscular blockade.
abstract: It was a prospective comparative clinical study carried out in the Department of Anaesthesia, Combined Military Hospital (CMH), Dhaka, to evaluate the heart rate changes during reversal of neuromuscular blockade by using 3 different doses of atropine (in a mixture with neostigmine) and thereby detect comparatively safer dose. Sixty patients of ASA (American Society of Anesthesiologists) grade I and II physical status were divided equally into 3 groups. Neostigmine 0.05 mg/kg body weight mixed with atropine 0.02, 0.015 and 0.01 mg/kg body weight given intravenously in group A, B and C respectively during reversal. The 3 groups were compared in age, sex, body weight, and ASA grades, but there was no significant difference (p>0.05) between 3 groups. It is revealed that in Group C (atropine at a dose of 0.01 mg/kg with neostigmine), heart rate affected very little but salivary and tracheobronchial secretions were more. One of them had laryngospasm which was managed conservatively. In Group B (who received atropine 0.015 mg/kg) incidence of tachycardia observed was less than Group A (who received atropine 0.02 mg/kg). The patients of this group also had some salivary secretions but less than group C. Tachycardia was most marked in Group A but had minimum salivary secretions. Statistical analysis of heart rate changes in different times among the 3 Groups was significant (p<0.05). It was highly significant (p<0.01) in 1 minute after reversal. So relatively lower dose (0.015 mg/kg) of atropine with neostigmine than the conventional dose (0.02mg/kg) can be used to decrease tachycardia during reversal of neuromuscular blockade especially in haemodynamically unstable patients.
authors.affiliation: CMH Mymensingh, Bangladesh.
authors.forename: M A
authors.initials: MA
authors.lastname: Islam
authors.forename: S M
authors.initials: SM
authors.lastname: Shahida
authors.forename: M R
authors.initials: MR
authors.lastname: Islam
authors.forename: M M
authors.initials: MM
authors.lastname: Haque
authors.forename: M H
authors.initials: MH
authors.lastname: Rashid
authors.forename: M H
authors.initials: MH
authors.lastname: Rashid
mesh_terms: D000328:Adult; D001285:Atropine / Q000494:pharmacology*; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009388:Neostigmine / Q000494:pharmacology; D019148:Neuromuscular Blockade; D011446:Prospective Studies
chemical_list: D009388:Neostigmine; D001285:Atropine