The effect of glycopyrrolate vs. atropine in combination with neostigmine on cardiovascular system for reversal of residual neuromuscular blockade in the elderly : a randomized controlled trial

© 2024. The Author(s)..

BACKGROUND: Glycopyrrolate-neostigmine (G/N) for reversing neuromuscular blockade (NMB) causes fewer changes in heart rate (HR) than atropine-neostigmine (A/N). This advantage may be especially beneficial for elderly patients. Therefore, this study aimed to compare the cardiovascular effects of G/N and A/N for the reversal of NMB in elderly patients.

METHODS: Elderly patients aged 65-80 years who were scheduled for elective non-cardiac surgery under general anesthesia were randomly assigned to the glycopyrrolate group (group G) or the atropine group (group A). Following the last administration of muscle relaxants for more than 30 min, group G received 4 ug/kg glycopyrrolate and 20 ug/kg neostigmine, while group A received 10 ug/kg atropine and 20 ug/kg neostigmine. HR, mean arterial pressure (MAP), and ST segment in lead II (ST-II) were measured 1 min before administration and 1-15 min after administration.

RESULTS: HR was significantly lower in group G compared to group A at 2-8 min after administration (P < 0.05). MAP was significantly lower in group G compared to group A at 1-4 min after administration (P < 0.05). ST-II was significantly depressed in group A compared to group G at 2, 3, 4, 5, 6, 7, 8, 9, 11, 13, 14, and 15 min after administration (P < 0.05).

CONCLUSIONS: In comparison to A/N, G/N for reversing residual NMB in the elderly has a more stable HR, MAP, and ST-II within 15 min after administration.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:24

Enthalten in:

BMC anesthesiology - 24(2024), 1 vom: 01. Apr., Seite 123

Sprache:

Englisch

Beteiligte Personen:

Wang, Yanping [VerfasserIn]
Ren, Liyuan [VerfasserIn]
Li, Yanshuang [VerfasserIn]
Zhou, Yinhui [VerfasserIn]
Yang, Jianjun [VerfasserIn]

Links:

Volltext

Themen:

3982TWQ96G
7C0697DR9I
Atropine
Cardiovascular system
Elderly
Glycopyrrolate
Journal Article
Neostigmine
Randomized Controlled Trial
V92SO9WP2I

Anmerkungen:

Date Completed 03.04.2024

Date Revised 04.04.2024

published: Electronic

Citation Status MEDLINE

doi:

10.1186/s12871-024-02512-x

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM370511514