Evaluation of the combined effects of glycopyrrolate and neostigmine on the lower oesophageal sphincter.

The effects on the lower oesophageal sphincter (LOS) of the simultaneous administration of glycopyrrolate 0.5 mg and neostigmine 2.5 mg, when given to antagonize neuromuscular blockade, were studied in 10 healthy patients undergoing gynaecological surgery. LOS pressure and gastric pressure (GP) were measured for 20 min after the administration of the drug combination and barrier pressure (BrP) was calculated (LOS-GP). There was a significant reduction in BrP which lasted, in some patients, for the duration of the study. These results contrast with those of a similar study looking at the effects of atropine and neostigmine in which the decrease in BrP, although significant, was transient, and in which control values were regained after 5 min.