Comparison of the effects of atropine and glycopyrrolate on cognitive function following general anaesthesia

Abstract

Tests of orientation, concentration and shortterm visual memory were used to assess 72 patients 1 day before, and 2 days after, elective major surgery. Patients were premedicated with papaveretum and either atropine or glycopyrrolate, before receiving a standard general anaesthetic. Those who had received atropine showed significant postoperative short-term memory deficit (P< 0.01), but no change in orientation or concentration. Those who had been given glycopyrrolate showed no significant cognitive changes after surgery. As glycopyrrolate does not cross the blood-brain barrier freely, these findings support the involvement of central cholinergic mechanisms in the deterioration of cognitive function in the postoperative period. © 1987 British Journal of Anaesthesia.