The Effects of Atropine and Neostigmine on Heart Rate and Rhythm

Rosner, V.; Kepes, Edith R.; Foldes, Francis F.

doi:10.1093/bja/43.11.1066

Cited by 31 publications

(15 citation statements)

References 2 publications

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“…There have been conflicting results on heart rates in previous studies [1][2][3][4][5]. Decreases in heart rate during antagonism of d-tubocurarine by neostigmine 2.5mg with atropine 1.0mg were of a lesser degree than those in this study [2].…”

Section: Control Atr()pine Neos-(igminecontrasting

confidence: 74%

“…Findings that the onset and the maximum effect of atropine are more rapid than those of neostigmine were observed by Rosner et al as changes in heart rate [5]. The small difference in the results between groups B and D may be caused by the different onset and duration of the two drugs.…”

Section: Control Atr()pine Neos-(igminementioning

confidence: 75%

“…Most anesthesiologists are using a combined injection with a ratio of 1 : 2 or 1 : 2.5 of atropine to neostigmine [2][3][4][5]. However, patients managed by these regimens Fig.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, we chose ratios 0f 1:1, 1:2, and 1:2.5 of atropine and neostigmine and assessed parasympathetic nervous activity under 0.5% isoflurane anesthesia. The parasympathetic effects of these agents have been studied with evaluation of changes in heart rate [1][2][3][4][5]. These studies were conducted under various conditions of anesthesia.…”

Section: Discussionmentioning

confidence: 99%

“…Lange doses of atropine, however, might be responsible for the development of cardiac arrhythmia. Rosner et al pointed out that prevention of excessive tachycardia is just as important as the avoidance of bradycardia [5].…”

Section: Control Atr()pine Neos-(igminementioning

confidence: 99%

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Parasympathetic nervous activity after administration of atropine and neostigmine using heart rate spectral analysis

et al. 1997

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Recently, heart rate spectral analysis has become recognized as a powerful tool for quantitatively evaluating autonomic nervous system activity. The purpose of this study was to analyze parasympathetic nervous activity by heart rate spectral analysis after administration of atropine and neostigmine for reversal of residual neuromuscular blockade. For our study, 36 female patients (26-37 years of age), ASA physical status (PS) I, who were scheduled for laparoscopic examination, were randomly allocated to one of the following four groups: In group A (1∶1), 9 patients received 1.0mg atropine followed 4 min later by 1.0 mg neostigmine. In group B (1∶2), 9 patients received 0.5 mg atropine followed 4 min later by 1.0 mg neostigmine. In group C (1∶2.5), 9 patients received 1.0 mg atropine followed 4 min later by 2.5 mg neostigmine. In group D (1∶2 mix), 9 patients received a mixed solution of atropine 0.5 mg and neostigmine 1.0mg. After finishing the laparoscopic examination, additional anesthesia was maintained with 70% nitrous oxide, 30% oxygen, and 0.5% isoflurane. The control data were obtained 10 min after finishing the laparoscopic examination. After that, the data on atropine were obtained between 2 and 4min after administration of atropine, and the data on neostigmine were obtained between 5 and 7 min after administration of neostigmine. We selected power spectral density of the high-frequency component (HF-p) in heart rate spectral analysis as an index to assess parasympathetic activity. In groups A, B, and C, the HF-p decreased after administration of atropine. In groups B and C, the HF-p increased after administration of neostigmine as compared to the control. In group A, the HF-p increased after neostigmine but did not differ from the control. The difference between groups D and B was not statistically significant. From the results of this study, we concluded that the muscarinic effect of neostigmine could not be sufficiently blocked by atropine at 1/2 dosages of neostigmine, but could be sufficiently blocked by atropine at equivalent dosages of neostigmine, under light isoflurane anesthesia.

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Section: Control Atr()pine Neos-(igminecontrasting

confidence: 74%

Section: Control Atr()pine Neos-(igminementioning

confidence: 75%

“…Most anesthesiologists are using a combined injection with a ratio of 1 : 2 or 1 : 2.5 of atropine to neostigmine [2][3][4][5]. However, patients managed by these regimens Fig.…”

Section: Discussionmentioning

confidence: 99%