Cardiovascular and autonomic nervous effects of edrophonium and atropine combinations during neuromuscular blockade antagonism in sheep

R. E. Clutton; M. A. Glasby

doi:10.1111/j.1467-2995.2007.00374.x

Cardiovascular and autonomic nervous effects of edrophonium and atropine combinations during neuromuscular blockade antagonism in sheep

Research output: Contribution to journal › Article › peer-review

Abstract

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 mu g kg(-1)) and high (80 mu g 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 mu g 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 mu g kg(-1)) administered 5 minutes later. Administered first, atropine (80 mu g 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 mu g kg(-1)) caused the mildest HR changes without ECG and noncardiac AN disturbances, and is recommended for the antagonism of NMB in sheep.

Original language	Undefined/Unknown
Pages (from-to)	191-200
Number of pages	10
Journal	Veterinary Anaesthesia and Analgesia
Volume	35
Issue number	3
DOIs	https://doi.org/10.1111/j.1467-2995.2007.00374.x
Publication status	Published - 2008

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10.1111/j.1467-2995.2007.00374.x

http://onlinelibrary.wiley.com/doi/10.1111/j.1467-2995.2007.00374.x/abstract

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@article{72d58fa9c5cf406e9f84fcc24fd25f47,

title = "Cardiovascular and autonomic nervous effects of edrophonium and atropine combinations during neuromuscular blockade antagonism in sheep",

abstract = "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 mu g kg(-1)) and high (80 mu g 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 mu g 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 mu g kg(-1)) administered 5 minutes later. Administered first, atropine (80 mu g 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 mu g kg(-1)) caused the mildest HR changes without ECG and noncardiac AN disturbances, and is recommended for the antagonism of NMB in sheep.",

author = "Clutton, \{R. E.\} and Glasby, \{M. A.\}",

note = "Times Cited: 2",

year = "2008",

doi = "10.1111/j.1467-2995.2007.00374.x",

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volume = "35",

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journal = "Veterinary Anaesthesia and Analgesia",

issn = "1467-2987",

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TY - JOUR

T1 - Cardiovascular and autonomic nervous effects of edrophonium and atropine combinations during neuromuscular blockade antagonism in sheep

AU - Clutton, R. E.

AU - Glasby, M. A.

N1 - Times Cited: 2

PY - 2008

Y1 - 2008

N2 - 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 mu g kg(-1)) and high (80 mu g 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 mu g 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 mu g kg(-1)) administered 5 minutes later. Administered first, atropine (80 mu g 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 mu g kg(-1)) caused the mildest HR changes without ECG and noncardiac AN disturbances, and is recommended for the antagonism of NMB in sheep.

AB - 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 mu g kg(-1)) and high (80 mu g 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 mu g 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 mu g kg(-1)) administered 5 minutes later. Administered first, atropine (80 mu g 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 mu g kg(-1)) caused the mildest HR changes without ECG and noncardiac AN disturbances, and is recommended for the antagonism of NMB in sheep.

U2 - 10.1111/j.1467-2995.2007.00374.x

DO - 10.1111/j.1467-2995.2007.00374.x

M3 - Article

SN - 1467-2987

VL - 35

SP - 191

EP - 200

JO - Veterinary Anaesthesia and Analgesia

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