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KMID : 0381219790110030067
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Journal of RIMSK
1979 Volume.11 No. 3 p.67 ~ p.72
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A Clinical Study of the Influence of Atropine and Neostigmine on Blood Pressure and Pulse Rate
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Abstract
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With few exception neuromuscular blockade by competitive blockers should be reversed by the appropriate use of facilitatory drugs at the end of operation. These drugs are quarternary ammonium compounds (for example: neostigmine, edrophonium and pyridostigmine) that fascilitate cholinergic transmission at various synaptic junctions throughout the body. Their actions are attributed to both anticholinesterase and direct cholinomimeticactivities, resulting in muscarinic effects and nicotinic effects.
The muscarinic effects of anticholinesterase are undesirable and therefore anesthesiolo-gists have traditionally been taught that a combination of anticholinergics and anticholinesterase mixed in the same syringe or separately is administered at the end of operations.
Recently much convincing evidence strongly suggests that the muscarinic effects, especially on the cardiovascular system are depend on whether a combination of both drugs or not, how the speed of injection and dosage.
To determine the cardiovascular effects of these drugs authors studied the changes of pulse rate and blood pressure according to the different methods using both atropine and. neostigmine.
The result are as follows:
1) In the intravenous use of atropine 1.0 mg and neostigmine 2.0 mg as reverse drugs of nondepolarizing neuromuscular blocking agent the blood pressure was not significantly influenced by the method (mixed in same syringe or separately) or the rate of administration.
2) Tachycardia was most markedly developed in the groups in which neostigmine: following atropine was administrated and the change was peaked(130%) at about 4 minutes.: after injection of atropine.
3) There was a similar effects on the decrease of pulse rate in all groups with the use of. atropine 1.0mg and neostigmine 2.0mg. The maximal change was -20% from the control
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