Summary
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 ± 0.15mg) 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.
Résumé
L’augmentation de l’activité muscarinique cardiaque causée par l’injection d’un anticholinesterase peut être minimisée par un médicament anticholinergique de longue durée, le glycopyrrolate. Chez 50 malades ayant reçu du glycopyrrolate (0.88 ± 0.15 mg) mélangé à la neostigmine (4.40 ± 0.66 mg) ou à la pyridostigmine (17.46 ± 2.92 mg) pour renverser le blocage neuro-musculaire, l’incidence des dysrythmies cardiaques post-opératoires a été de 16 pour cent. Toutes ces dysrythmies sont survenues chez des malades qui présentaient déjà une maladie cardio-vasculaire. L’analyse statistique n’a pas révélé de rapport significatif entre l’incidence des troubles du rythme et la technique anesthésique ou le choix de l’anticholinestérase.
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Study supported in part by a grant from the A.H. Robins Company, Richmond, Virginia.
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Muravchick, S., Owens, W.D. & Felts, J.A. Glycopyrrolate and cardiac dysrhythmias in geriatric patients after reversal of neuromuscular blockade. Canad. Anaesth. Soc. J. 26, 22–25 (1979). https://doi.org/10.1007/BF03039448
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DOI: https://doi.org/10.1007/BF03039448