PDF(Pubmed)
Abstract：
BACKGROUND: Glycopyrrolate-neostigmine (G/N) for reversing neuromuscular blockade (NMB) causes fewer changes in heart rate (HR) than atropine-neostigmine (A/N). This advantage may be especially beneficial for elderly patients. Therefore, this study aimed to compare the cardiovascular effects of G/N and A/N for the reversal of NMB in elderly patients.
METHODS: Elderly patients aged 65-80 years who were scheduled for elective non-cardiac surgery under general anesthesia were randomly assigned to the glycopyrrolate group (group G) or the atropine group (group A). Following the last administration of muscle relaxants for more than 30 min, group G received 4 ug/kg glycopyrrolate and 20 ug/kg neostigmine, while group A received 10 ug/kg atropine and 20 ug/kg neostigmine. HR, mean arterial pressure (MAP), and ST segment in lead II (ST-II) were measured 1 min before administration and 1-15 min after administration.
RESULTS: HR was significantly lower in group G compared to group A at 2-8 min after administration (P < 0.05). MAP was significantly lower in group G compared to group A at 1-4 min after administration (P < 0.05). ST-II was significantly depressed in group A compared to group G at 2, 3, 4, 5, 6, 7, 8, 9, 11, 13, 14, and 15 min after administration (P < 0.05).
CONCLUSIONS: In comparison to A/N, G/N for reversing residual NMB in the elderly has a more stable HR, MAP, and ST-II within 15 min after administration.
METHODS: Elderly patients aged 65-80 years who were scheduled for elective non-cardiac surgery under general anesthesia were randomly assigned to the glycopyrrolate group (group G) or the atropine group (group A). Following the last administration of muscle relaxants for more than 30 min, group G received 4 ug/kg glycopyrrolate and 20 ug/kg neostigmine, while group A received 10 ug/kg atropine and 20 ug/kg neostigmine. HR, mean arterial pressure (MAP), and ST segment in lead II (ST-II) were measured 1 min before administration and 1-15 min after administration.
RESULTS: HR was significantly lower in group G compared to group A at 2-8 min after administration (P < 0.05). MAP was significantly lower in group G compared to group A at 1-4 min after administration (P < 0.05). ST-II was significantly depressed in group A compared to group G at 2, 3, 4, 5, 6, 7, 8, 9, 11, 13, 14, and 15 min after administration (P < 0.05).
CONCLUSIONS: In comparison to A/N, G/N for reversing residual NMB in the elderly has a more stable HR, MAP, and ST-II within 15 min after administration.
摘要：
背景：格隆溴铵-新斯的明（G/N）逆转神经肌肉阻滞（NMB）比阿托品-新斯的明（A/N）引起的心率（HR）变化更少。这个优点对于老年患者可能是特别有益的。因此,本研究旨在比较G/N和A/N逆转老年患者NMB的心血管作用。
方法：将65-80岁的老年患者在全身麻醉下进行择期非心脏手术，随机分为格隆溴铵组（G组）或阿托品组（A组）。在最后一次施用肌肉松弛剂超过30分钟后，G组接受4ug/kg格隆溴铵和20ug/kg新斯的明，而A组接受10ug/kg阿托品和20ug/kg新斯的明。HR,平均动脉压(MAP),在给药前1分钟和给药后1-15分钟测量II导联（ST-II）的ST段。
结果：给药后2-8min，G组HR明显低于A组（P<0.05）。给药后1~4min,G组MAP明显低于A组(P<0.05)。给药后2、3、4、5、6、7、8、9、11、13、14、15min,A组ST-II明显低于G组(P<0.05)。
结论：与A/N相比，G/N对于逆转残余NMB在老年人中具有更稳定的HR，MAP,和ST-II在给药后15分钟内。
方法：将65-80岁的老年患者在全身麻醉下进行择期非心脏手术，随机分为格隆溴铵组（G组）或阿托品组（A组）。在最后一次施用肌肉松弛剂超过30分钟后，G组接受4ug/kg格隆溴铵和20ug/kg新斯的明，而A组接受10ug/kg阿托品和20ug/kg新斯的明。HR,平均动脉压(MAP),在给药前1分钟和给药后1-15分钟测量II导联（ST-II）的ST段。
结果：给药后2-8min，G组HR明显低于A组（P<0.05）。给药后1~4min,G组MAP明显低于A组(P<0.05)。给药后2、3、4、5、6、7、8、9、11、13、14、15min,A组ST-II明显低于G组(P<0.05)。
结论：与A/N相比，G/N对于逆转残余NMB在老年人中具有更稳定的HR，MAP,和ST-II在给药后15分钟内。
