Wetterslev J, Jarnvig I, Jørgensen L N, Olsen N V
Department of Anaesthesia, Frederiksberg Hospital, Denmark.
Acta Anaesthesiol Scand. 1991 Jul;35(5):398-401. doi: 10.1111/j.1399-6576.1991.tb03317.x.
The effects of a split-dose of atropine sulphate versus a single dose of glycopyrrolate given with neostigmine for the reversal of gallamine-induced neuromuscular blockade were studied in 55 patients undergoing gynaecological surgery. The patients were randomized to receive either a single dose of glycopyrrolate (7 micrograms.kg-1) or two doses of atropine (8 micrograms.kg-1 each), given with an interval of 1 min. There were no differences between the two methods with respect to percentage heart rate changes, salivation or arousal time. Four patients demonstrated cardiac arhythmias in the atropine group, whereas none occurred in the glycopyrrolate group (P less than 0.05). It is concluded that a split-dose of atropine has similar chronotropic effects to a single dose of glycopyrrolate for the reversal of gallamine-induced neuromuscular blockade. However, the finding of a higher incidence of cardiac arrhythmias in the atropine group suggests that this reversal regime should be reserved for patients without cardiac disease.
在55例接受妇科手术的患者中，研究了硫酸阿托品分剂量给药与单剂量格隆溴铵联合新斯的明用于逆转加拉明引起的神经肌肉阻滞的效果。患者被随机分为两组，分别接受单剂量格隆溴铵（7微克/千克）或两剂量阿托品（每次8微克/千克），给药间隔为1分钟。两种方法在心率变化百分比、唾液分泌或苏醒时间方面没有差异。阿托品组有4例患者出现心律失常，而格隆溴铵组未出现（P<0.05）。结论是，对于逆转加拉明引起的神经肌肉阻滞，阿托品分剂量给药与单剂量格隆溴铵具有相似的变时作用。然而，阿托品组心律失常发生率较高的结果表明，这种逆转方案应仅用于无心脏病的患者。
