Comparison of haemodynamic responses between atropine and glycopyrrolate used with neostigmine during reversal of neuromuscular blockade

ABSTRACT

The aim of the study was to compare the haemodynamic responses between atropine and glycopyrrolate used with neostigmine during reversal of neuromuscular blockade. The experimental study was conducted in the Department of Anesthesia, Sindh Govt Lyari General Hospital over a period of 6 months from February 2009 to July 2009. In this study we included total sixty patients undergoing elective surgeries. These patients were allocated into two equal groups. The patients in group I received inj Neostigmine 0.04 mg/kg with inj atropine 0.4 mg/1 mg neostigmine and the patients in group II were given inj neostigmine 0.04 mg/kg with inj. Glycopyrrolate 0.2mg/1 mg neostigmine at the end of the surgery. In both the groups heart rate and blood pressures were recorded as a base line value prior to administration of reversal agents and then after 1, 5, and 10 minutes interval after giving the reversal agents. The comparison was made between groups I and group II. Out of 60 patients 37 [61.66%] were males and 23 [3 8.33%] were females with 1.61 male to female ratio. The base line mean heart rate, systolic and diastolic blood pressure readings in group I were 75.13 +/- 5.23, 130.18 +/- 7.1 and 75.22 +/- 4.37 respectively while in group II these readings were 71.19 +/- 4.21, 121.12 +/- 11.52 and 75.77 +/- 3.61 respectively. Mean heart rate and systolic blood pressure readings between groups at 1, 5 and 10 minutes were statistically significant while diastolic blood pressure readings between groups were significant only at 5 minutes. Glycopyrrolate, in comparison to atropine, is more effective in providing cardiovascular stability in antagonizing the muscarinic cardiovascular effects of neostigmine