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British Journal of Anaesthesia, 1989, Vol. 62, No. 1 77-81
© 1989 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

GLYCOPYRRONIUM REQUIREMENTS FOR ANTAGONISM OF THE MUSCARINIC SIDE EFFECTS OF EDROPHONIUM{dagger}

P. DODD, M.B.B.S., F.F.A.R.C.S.I., S. J. DAY, B.SC.*, D. R. GOLDHILL, M.B.B.S., F.F.A.R.C.S., D. M. MACLEOD, M.B. CH.B., F.FA.R.CS.I., P. S. WITHINGTON, M.B.B.S., F.F.A.R.C.S. and P. M. YATE, M.B.B.S., F.F.A.R.C.S.

Anaesthetic Unit, The London Hospital Medical College Turner Street, London E1 2AD
Anaesthetic Department; The London Hospital, Whitechapel London E1 IBB
Department of Clinical Epidemiology; The London Hospital Whitechapel, London E1 IBB

We have compared, in 60 adult patients, the cardiovascular effects of glycopyrronium 5 µg kg–1 and 10 µg kg–1 given either simultaneously or 1 min before edrophonium 1 µg kg–1. Significant differences between the four groups were detected (P < 0.001). Both groups receiving 10 µg kg–1 showed increases in heart rate of up to 30 beat min-1 (95% confidence limits 28–32 beat min-1). Use of glycopyrronium 5 µg kg–1 provided greater cardiovascular stability and, given 1 min before the edrophonium, was sufficient to minimize early, edrophonium-induced bradycardias. This low dose of glycoprronium provided good control of oropharyngeal secretions.

*Present address: Respiratory Unit, The Hospital for Sick Children, Great Ormond Street, London W. 1.

{dagger}Presented in part at the June 1987 meeting of the Anaesthetic Research Society.


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