0.6 vs. 1.2 mg Atropine Together With Neostigmine 2.5 mg on Heart Rate in Patient Receiving Muscle Relaxant
Status:
Completed
Trial end date:
2013-02-01
Target enrollment:
Participant gender:
Summary
Balanced general anesthesia with neuromuscular blocking agents has been widely used for
surgery.. At the end of surgery, neostigmine has been given for the reversal of neuromuscular
blocking agents with several adverse effects such as bradycardia and profuse secretion.
Atropine has been used to prevent those side effects of neostigmine. The routine dosages of
the two drugs are 2.5 mg of neostigmine and 1.2 mg of atropine.
Tribuddharat S ey al. (1) has demonstrated that after giving 0.9 mg atropine together with
2.5 mg of neostigmine the mean heart rate during 1-8 minutes after the administration was
increase 2-26 beats/min (bpm). At 9 and 10 minutes after administration of the drugs, the
mean heart rate were decrease 0.9 and 1.6 bpm In the control group which receiving 1.2 mg of
atropine, the mean heart rate during 1-10 minutes after administration was increase 4-32 bpm.
However this study did not report the incidence of bradycardia and blood pressure. The mean
heart rate prior to atropine and neostigmine was 74.43 + 11.82 bpm.(1)
Salem MG et al. (2) has demonstrated that after receiving 1.2 mg of atropine and 5 mg of
neostigmine the mean heart rate during 2-110 minutes was decrease 5-29 bpm with the lowest
heart rate at 40 minutes after administration. This study also did not report the blood
pressure.
The baseline heart rate (HR) before administration of the reversal was associated with the
following heart rate. Heinonen J et al. (3) has demonstrated that 80% of the patients after
receiving 0.015 mg/kg of atropine 3 minutes before 0.03 mg of neostigmine for the reversal of
pancuronium experienced bradycardia (heart rate < 50 bpm) compared with none in patients
receiving alcuronium. However, before administration of atropine and neostigmine, the mean
heart rate of patients was significantly lower in the pancuronium group.
Either tachycardia or bradycardia with hypotension causes adverse affect to patient
especially in specific group like patient with coronary artery disease or undergoing
craniotomy.
The primary objective of our study is to demonstrate the effect on heart rate (HR) and blood
pressure of 0.6 mg atropine and 2.5 mg neostigmine for the reversal of muscle relaxant
compare to 1.2 mg atropine.