Why the study?
Does glycopyrrolate or hyoscine compared to atropine improve heart rate stability and secretion control when mixed with neostigmine for reversal of neuromuscular block in patients undergoing closed mitral valvotomy?
Does glycopyrrolate or hyoscine compared to atropine improve heart rate stability and secretion control when mixed with neostigmine for reversal of neuromuscular block in patients undergoing closed mitral valvotomy?
Glycopyrrolate is preferable to atropine or hyoscine for reversing neuromuscular block with neostigmine in patients with mitral stenosis due to better heart rate stability and secretion control.
Hypothesis-generating for glycopyrrolate in neostigmine reversal for mitral stenosis; prospective RCTs required before practice consideration.
Atropine, glycopyrrolate and hyoscine were compared in a mixture with neostigmine for the reversal of neuromuscular block in patients undergoing closed mitral valvotomy. Both atropine and glycopyrrolate were effective in counteracting the muscarinic effects of neostigmine. Glycopyrrolate was, associated with less initial increase in heart rate, a factor of importance in patients with mitral stenosis. The incidence of significant dysrhythmias was low in this small series. The control of secretions was better with glycopyrrolate. Administration of hyoscine was associated with unacceptable falls in heart rate and is not recommended.
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Bali et al. (1980) studied this question.
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