ABSTRACT
Eighteen male patients undergoing elective surgical reconstruction of the abdominal aorta were divided into two groups. Patients in Group I (nine) were given dopamine intravenously, in a dose of 2 micrograms/kg/min, during the first half of the period of cross-clamping, whilst those in Group II received dopamine during the second half. Each patient acted as his own control and for each, three periods were examined, namely: pre-clamp, clamping with dopamine and clamping without dopamine. Dopamine infusion during aortic clamping caused a significant rise in sodium output (P less than 0.01), potassium output (P less than 0.05), creatinine clearance (P less than 0.05) and urine output (P less than 0.05). We conclude that dopamine infusion during aortic clamping helps to protect the kidney from any deleterious effect of clamping.
Subject(s)
Aorta, Abdominal/surgery , Dopamine/pharmacology , Kidney/drug effects , Aged , Aged, 80 and over , Blood Pressure/drug effects , Constriction , Creatinine/metabolism , Diuresis/drug effects , Electrolytes/urine , Humans , Male , Middle Aged , Osmolar Concentration , Renin/bloodABSTRACT
One hundred and fifteen patients, separated into 4 groups, received neostigmine 5 mg with either atropine 1.2 mg or 1.8 mg, or glycopyrrolate 0.6 mg or 0.9 mg. Those receiving 0.9 mg glycopyrrolate had insignificant changes in heart rate in the immediate postreversal period. It is recommended that when glycopyrrolate is used with 5 mg neostigmine, the optimum dose is 0.9 mg.
Subject(s)
Atropine/administration & dosage , Glycopyrrolate/administration & dosage , Neostigmine/administration & dosage , Pyrrolidines/administration & dosage , Anesthesia, General , Atropine/pharmacology , Dose-Response Relationship, Drug , Female , Glycopyrrolate/pharmacology , Heart Rate/drug effects , Humans , Male , Middle Aged , Neostigmine/pharmacologyABSTRACT
Atropine and glycopyrrolate were compared in a mixture with neostigmine for reversal of neuromuscular blockade in patients undergoing open heart surgery. In patients not receiving beta-blocking drugs, glycopyrrolate was shown to possess advantages over atropine in terms of a lower initial increase in heart rate, better protection against the muscarinic effects of neostigmine, and smaller increases in rate-pressure product. The concomitant administration of beta-adrenergic blocking therapy significantly attenuated the effect of reversal on heart rate and the differences between atropine and glycopyrrolate were not significant. There was no difference in the incidence of arrhythmias between patients who received beta-blocking drugs and those who did not.
Subject(s)
Atropine/pharmacology , Glycopyrrolate/pharmacology , Neostigmine/pharmacology , Neuromuscular Junction/drug effects , Pyrrolidines/pharmacology , Adrenergic beta-Antagonists/therapeutic use , Blood Pressure/drug effects , Cardiac Surgical Procedures , Drug Combinations , Heart Rate/drug effects , Humans , Middle Aged , Pancuronium/antagonists & inhibitors , Time FactorsABSTRACT
The effects of glycopyrrolate 0.2 mg and atropine 0.6 mg, given intravenously, were studied in 40 elderly patients undergoing intra-ocular surgery. Twenty patients had normal intra-ocular pressure (IOP) and 20 had raised IOP. The effects of each of the drugs on IOP, heart rate, prevention of the oculocardiac reflex and incidence of dysrhythmias were assessed. Anaesthesia with thiopentone, suxamethonium, nitrous oxide/oxygen, and halothane, using a semiclosed circle system resulted in a decrease in mean IOP in both the atropine and glycopyrrolate groups. Patients who had pre-existing raised IOP showed a significantly greater decrease in IOP than those with normal IOP. Patients with raised IOP who had received atropine experienced a greater decrease in IOP than those who had received glycopyrrolate. Both atropine and glycopyrrolate were effective in preventing the oculocardiac reflex. The increase in heart rate was greater in those patients who had received atropine. The incidence of dysrhythmias was low.
Subject(s)
Anesthesia, General , Atropine/pharmacology , Glycopyrrolate/pharmacology , Intraocular Pressure/drug effects , Pyrrolidines/pharmacology , Aged , Heart Rate/drug effects , Humans , Ophthalmologic Surgical Procedures , Reflex, Oculocardiac/drug effects , Time FactorsABSTRACT
Glycopyrrolate, atropine or saline were administered i.v. with oral magnesium trisilicate 1 h before induction of anaesthesia to patients about to undergo Caesarean section. Both anticholinergics greatly reduced gastric acidity. It is suggested that glycopyrrolate should be used in combination with antacid therapy before obstetric anaesthesia and puerperal tubal ligation because of its prolonged duration of action, effect on gastric secretion and failure to cross the placental barrier.
