Glycopyrrolate and cardiac dysrhythmias in geriatric patients after reversal of neuromuscular blockade

Abstract

The increase in cardiac muscarinic activity following injection of anticholinesterases can be minimized by the long-acting anticholinergic drug glycopyrrolate. In a series of 50 patients 65 years of age or older who had received glycopyrrolate (0.88 ± 0.15mg) mixed with neostigmine (4.40 ± 0.66 mg) or pyridostigmine (17.46 ± 2.92 mg) to antagonize neuromuscular blockade, the incidence of new postoperative cardiac dysrhythmias was 16 per cent. All dysrhythmias occurred in patients with pre-existing cardiovascular disease. There was no statistically significant relationship between the incidence of cardiac dysrhythmias and the choice of anaesthetic technique or anticholinesterase drug. © 1979 Canadian Anesthesiologists.