Cognitive visual perceptual deficits in delerium

L. J. Brown, S. McGrory, L. McLaren, J. M. Starr, I. J. Deary, A. M. J. MacLullich

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

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 micro g kg-1) and high (80 micro 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 micro 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-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 micro g kg-1) administered 5 minutes later. Administered first, atropine (80 micro 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 micro 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 languageEnglish
JournalJournal of Neurology, Neurosurgery & Psychiatry
Publication statusPublished - 2009

Keywords / Materials (for Non-textual outputs)

  • Animal Physiology and Biochemistry (Excluding Nutrition) [LL600]
  • Veterinary Pharmacology and Anaesthesiology [LL882]
  • antagonists
  • arrhythmia
  • atropine
  • autonomic nervous system
  • blood pressure
  • dosage effects
  • drug combinations
  • electrocardiography
  • ewes
  • haemodynamics
  • heart rate
  • potency
  • sheep
  • Ovis
  • Bovidae
  • ruminants
  • Artiodactyla
  • mammals
  • vertebrates
  • Chordata
  • animals
  • ungulates
  • eukaryotes
  • edrophonium
  • hemodynamics
  • parasympathetic system

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