SAEEDA HAIDER, SADIA QURESHI, FAUZIA BANO, Saeeda Haider, Fauzia Bano.
A comparison of Glycopyrrolate & Atropine in combination with Neostigmine for the reversal of non-depolarizing neuromuscular block in Pakistani population.
Med Channel Jan ;10(2):23-6.

OBJECTIVE: The study was conducted to compare the efficacy & safety of glycopyrrolate & atropine required to antagonize the muscarinic cardiovascular effects of neostigmine for reversal of neuromuscular block. DESIGN: It was a double blinded, interventional experimental study. PLACE AND DURATION OF STUDY: This study was conducted at the Department of Anesthesiology and Surgical Intensive Care Unit, Dow Medical College and Civil Hospital Karachi from January 1, 2001 - July 30, 2001 PATIENTS AND METHODS: Sixty patients, both male and female, aged 16-60 years, ASA physical status I and II, undergoing abdominal surgery were randomly allocated to receive either injection neostigmine 0.04 mg/kg and injection glycopyrrolate 0.01 mg/kg (group A) or injection neostigmine 0.04 mg/kg and injection atropine 0.015 mg/kg (group B) for the reversal of pancuronium induced neuromuscular blockade at the end of surgery. The heart rate & blood pressure were recorded at 1, 5, 10 & 15 minutes interval after giving the reversal agents. RESULT: The increase in heart rate at 1 minute interval was significantly less in glycopyrrolate group (p < 0.001). The mean heart rate at 5 minutes were 86.30±5.50 in the glycopyrrolate group and 84.23±7.71 in atropine group which was statistically insignificant (p=0.237), while at 10 & 15 minutes interval atropine group showed significant decrease in heart rate (p=0.023 & p=0.001 respectively). There were no significant changes in the blood pressure in both groups (p >0.05). CONCLUSION: It is suggested that in comparison to atropine, glycopyrrolate is more effective in providing cardiovascular stability in antagonizing the muscarinic cardiovascular effects of neostigmine

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