Does glycopyrrolate 0.9 mg with neostigmine 5 mg prevent changes in heart rate in the immediate postreversal period in patients?
When glycopyrrolate is used with 5 mg neostigmine for reversal, the optimum dose to minimize heart rate changes is 0.9 mg.
One hundred and fifteen patients, separated into 4 groups, received neostigmine 5 mg with either atropine 1.2 mg or 1.8 mg, or glycopyrrolate 0.6 mg or 0.9 mg. Those receiving 0.9 mg glycopyrrolate had insignificant changes in heart rate in the immediate postreversal period. It is recommended that when glycopyrrolate is used with 5 mg neostigmine, the optimum dose is 0.9 mg.
Salem et al. (1986) studied this question.