Antagonism of neuromuscular blockade

Glycopyrronium 5 or 10 micrograms/kg was administered either simultaneously with, or 1 minute before, edrophonium 1 mg/kg in order to antagonise competitive neuromuscular blockade in 80 children. Both doses of glycopyrronium given before the edrophonium resulted in an initial significant (p less than 0.01) increase in heart rate. Heart rate decreased significantly (p less than 0.01) in all groups after the edrophonium was given, and only glycopyrronium 10 micrograms/kg administered before edrophonium prevented a substantial decrease below baseline. Initial heart rate responses to glycopyrronium or edrophonium are rapid, and measurements at intervals of 30 seconds may be necessary to record these changes.