Reversal of neuromuscular blockade by glycopyrrolate and neostigmine |
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Authors: | JG BROCK-UTNE |
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Institution: | J.G. Brock-Utne MA, MB, BCh, FFA(SA), Cand. Med. (Bergen) Principal Anaesthetist/Senior Lecturer, Department of Anaesthetics, University of Natal and King Edward VIII Hospital, P.O. Box 17039, Congella 4013, Durban, Republic of South Africa. |
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Abstract: | The effect of intravenous glycopyrrolate and neostigmine, a drug combination routinely given to antagonize non-depolarising neuromuscular blockade, on lower oesophageal sphincter tone was studied in twenty patients undergoing Caesarean section. Glycopyrrolate 0.6 mg and neostigmine 2.5 mg i.v. increased LOS pressure insignificantly by a mean of 0.2 kPa (P less than 0.1). In contrast, glycopyrrolate 0.6 mg and neostigmine 5 mg increased LOS pressure by a mean of 1.2 kPa (P less than 0.001). The latter dosage of this drug combination thus appears preferable in patients presenting for emergency surgery, if the integrity of the lower oesophageal sphincter is to be maintained during extubation and recovery from general anaesthesia. |
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Keywords: | ANTAGONISTS NEUROMUSCULAR RELAXANTS atropine neostigmine glycopyrrolate GASTROINTESTINAL TRACT oesophagus LUNG aspiration |
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