Advantages of Glycopyrrolate over Atropine during Reversal of Pancuronium Block

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Abstract
Atropine 0.015 mg/kg and glycopyrrolate 0.0075 mg/kg were compared as antimuscarinic agents during reversal of pancuronium block with neostigmine 0.03 mg/kg in 30 patients anesthetized with thiopental-N2O-fentanyl and undergoing minor surgery. The decrease of heart rate was more pronounced in patients who received atropine-neostigmine. The mean of the lowest heart rate was 44.3 beats/min in the atropine group compared with 54.3 beats/min in the glycopyrrolate group. Five patients treated with atropine-neostigmine developed a transient nodal rhythm as compared with 2 of those receiving glycopyrrolate-neostigmine (nonsignificant difference). Recovery from anesthesia, as assessed by the awakening after the discontinuation of N2O administration, was more rapid in patients given glycopyrrolate. Glycopyrrolate seems to have advantages over atropine when used during reversal of pancuronium block with neostigmine.