Document Detail


Cardiovascular and autonomic nervous effects of edrophonium and atropine combinations during neuromuscular blockade antagonism in sheep.
MedLine Citation:
PMID:  18282258     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To study heart rate (HR), arterial blood pressure (BP) and autonomic nervous (AN) effects of edrophonium-atropine combinations during neuromuscular blockade (NMB) antagonism in sheep. EXPERIMENTAL DESIGN: Randomized, prospective and experimental study. ANIMALS: Seventy-eight Scottish blackface ewes; mean age: 4.5 years; mean body mass: 54 kg. METHODS: After induction with IV etomidate (0.5 mg kg(-1)) and midazolam (0.5 mg kg(-1)), anaesthesia was maintained with halothane and NMB produced with atracurium or mivacurium. In the first study (n = 53), the electrocardiographic (ECG), HR, BP and AN effects of low (40 microg kg(-1)) and high (80 microg kg(-1)) atropine doses combined with either of two edrophonium doses (0.5 or 1.0 mg kg(-1)) were investigated. These variables were also measured in a second study when edrophonium (1.0 mg kg(-1)) was administered 5 minutes before atropine (80 microg kg(-1)) and vice versa. Data were analysed using one-way within-subjects and repeated measures anova. RESULTS: In the first study, all combinations reversed NMB but significantly (p < 0.001) increased HR and BP within 2 minutes without arrhythmias. In the second study, edrophonium (1.0 mg kg(-1)) significantly increased HR and BP, saliva flow (n = 1) and lung sounds (n = 3) and caused ECG changes (n = 1). Cardiovascular changes were partially reversed by atropine (80 microg kg(-1)) administered 5 minutes later. Administered first, atropine (80 microg kg(-1)) significantly decreased HR and BP effects which were fully (HR) and partially (BP) reversed by edrophonium (1 mg kg(-1)) administered 5 minutes later. CONCLUSION AND CLINICAL RELEVANCE: The cardiovascular effects of edrophonium and atropine were opposite to those reported in humans and dogs. Edrophonium (0.5 mg kg(-1)) and atropine (80 microg kg(-1)) caused the mildest HR changes without ECG and noncardiac AN disturbances, and is recommended for the antagonism of NMB in sheep.
Authors:
R Eddie Clutton; Michael A Glasby
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2008-02-18
Journal Detail:
Title:  Veterinary anaesthesia and analgesia     Volume:  35     ISSN:  1467-2995     ISO Abbreviation:  Vet Anaesth Analg     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-05-07     Completed Date:  2008-10-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100956422     Medline TA:  Vet Anaesth Analg     Country:  England    
Other Details:
Languages:  eng     Pagination:  191-200     Citation Subset:  IM    
Affiliation:
Department of Veterinary Clinical Sciences, Royal (Dick) School of Veterinary Studies, Easter Bush, Roslin, Midlothian, UK. e.clutton@ed.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Anesthesia / veterinary
Animals
Atracurium / antagonists & inhibitors,  pharmacology
Atropine / administration & dosage*,  pharmacology*
Blood Pressure / drug effects
Cholinesterase Inhibitors / administration & dosage,  pharmacology
Drug Therapy, Combination
Edrophonium / administration & dosage*,  pharmacology*
Female
Heart Rate / drug effects
Isoquinolines / antagonists & inhibitors,  pharmacology
Muscarinic Antagonists / administration & dosage,  pharmacology
Neuromuscular Blockade / veterinary*
Neuromuscular Blocking Agents / antagonists & inhibitors,  pharmacology
Sheep*
Chemical
Reg. No./Substance:
0/Cholinesterase Inhibitors; 0/Isoquinolines; 0/Muscarinic Antagonists; 0/Neuromuscular Blocking Agents; 106791-40-6/mivacurium; 312-48-1/Edrophonium; 51-55-8/Atropine; 64228-79-1/Atracurium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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