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Canadian Journal of Anesthesia, Vol 29, 573-576, Copyright © 1982 by Canadian Anesthesiologists' Society

Effect of Atropine on Bradydysrhythmias Induced by Succinylcholine Following Pretreatment with D-Tubocurarine

D. A. MAGEE M.B., B.Ch., F.F.A.R.C.S.I.1, P. T. SWEET M.B., Bs.,(Lond.) F.F.A.R.C.S.1, and A.J. C. HOLLAND M.B., Bs., F.F.A.R.C.S., D.C.H.1

1 Department of Anaesthesia, McGill University and the Montreal General Hospital

Requests for reprints and correspondence: Dr. D.A. Magee c/o Department of Anaesthesia, Regional Hospital, Galway, County Galway, Ireland.

This study was designed to compare the effectiveness of pretreatment with the combination of d-tubocurarine and atropine with d-tubocurarine alone in preventing changes in cardiac rate and rhythm following repeated administration of succinylcholine. Sixty subjects were randomly divided into three groups of twenty. Group one received d-tubocurarine 0.04 mg·kg-1 and atropine 0.01 mg·kg-1, and group two d-tubocurarine 0.04 mg·kg-1 only, given three minutes before induction of anaesthesia. Group three received no pretreatment. Immediately following thiopentone induction succinylcholine 1 mg·kg-1 was given to all patients. A further dose of succinylcholine 1 mg·kg-1 was given to patients in the pretreatment groups following recovery of neuro-muscular function. Both pretreatment groups showed a small statistically significant fall in mean heart rate after the second dose of succinylcholine. One patient in each pretreatment group showed a fall in heart rate to less than 50 beats min-1; two patients in the group who received both d-tubocurarine and atropine, and three patients in the d-tubocurarine only group, showed a fall in heart rate of 25 per cent or more. It is concluded that the addition of atropine may be unnecessary for prevention of succinylcholine-induced bradydysrhythmias when d-tubocurarine pretreatment is given.

Key Words: NEUROMUSCULAR RELAXANTS, succinylcholine, d-tubocurarine • ANTICHOLINERGICS, atropine • COMPLICATIONS, bradydysrhythmia






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Copyright © 1982 by the Canadian Anesthesiologists' Society.