Mostafa S M, Vucevic M
Anaesthesia. 1984 Dec;39(12):1207-13. doi: 10.1111/j.1365-2044.1984.tb06433.x.
The effects of atropine and glycopyrronium, when given intravenously with neostigmine during the reversal of neuromuscular blockade in patients with cardiovascular disease, were compared in a double blind trial. Atropine was associated with a significantly greater elevation of heart rate and rate-pressure product than glycopyrronium. This elevation was also more sustained with atropine. The entire atropine population also showed a significantly greater incidence of ST-segment depression on the electrocardiogram than that observed in those who had received glycopyrronium. Furthermore, patients with ischaemic heart disease and previous myocardial infarction who received atropine showed a significantly greater incidence of dysrhythmias than those given glycopyrronium. It is suggested that at the time of reversal of neuromuscular blockade in patients with cardiovascular disease, glycopyrronium is a more suitable agent than atropine.
在一项双盲试验中，比较了在心血管疾病患者神经肌肉阻滞逆转期间静脉注射阿托品和格隆溴铵并同时使用新斯的明的效果。与格隆溴铵相比，阿托品与心率和率压乘积的显著升高有关。阿托品引起的这种升高也更持久。整个使用阿托品的人群心电图上ST段压低的发生率也显著高于使用格隆溴铵的人群。此外，患有缺血性心脏病和既往心肌梗死且接受阿托品治疗的患者心律失常的发生率显著高于接受格隆溴铵治疗的患者。建议在心血管疾病患者神经肌肉阻滞逆转时，格隆溴铵比阿托品更适合作为用药。
