British journal of anaesthesia
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Randomized Controlled Trial Clinical Trial
Evaluation of glycopyrrolate and atropine as adjuncts to reversal of non-depolarizing neuromuscular blocking agents in a "true-to-life" situation.
Glycopyrrolate, a quaternary ammonium anticholinergic compound, and atropine were evaluated in combination with neostigmine for antagonism of non-depolarizing neuromuscular block. A total of 641 patients were investigated in a "true-to-life" situation. The patients receiving glycopyrrolate with neostigmine had smaller changes in heart rate than those who received atropine. This was particularly apparent in patients with cardiovascular disease.
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Before the induction of labour in 34 pregnant women 1.5% lignocaine 10 ml was injected into the lumbar extradural space at constant rates between 0.143 and 0.333 ml s-1. Injection pressures and residual pressures were recorded and the extent of analgesia to pinprick was assessed. ⋯ Analgesia was significantly more extensive on the side dependent during injections, but there was no significant correlation between the overall extent of analgesia and the rate of injection, injection pressures or residual pressures in the extradural space. It is concluded that there is no advantage from rapid extradural injections.
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Comparative Study
Pharmacology of ORG NC 45 compared with other non-depolarizing neuromuscular blocking drugs.
From results of pharmacological tests on the neuromuscular and autonomic blocking actions of a series of pancuronium analogues, Org NC 45, the C16 monoquaternary analogue of pancuronium, was selected for detailed study. Org NC 45 has a non-depolarizing mechanism of action, is more rapid in onset and shorter in duration of action than pancuronium. It shows less cumulation than pancuronium or tubocurarine, and is easily antagonized by anticholinesterases and aminopyridines. ⋯ Thus cardiovascular side-effects are unlikely to occur with the use of Org NC 45. It will hydrolyse mainly to its 3-hydroxy analogue which, like Org NC 45, possesses a wide margin between neuromuscular and vagal blocking doses. Org NC 45 has a high selectivity for the neuromuscular junction and represents a potentially useful addition to the armamentarium of clinically useful muscle relaxants.