Related Experiment Video
Updated: Aug 18, 2026
Electrocardiogram Recordings in Anesthetized Mice using Lead II
Published on: June 20, 2020
[Atropine versus glycopyrrolate in eye surgery. A comparison of rhythm disorders and heart frequency using
G G Braun1, M Schywalsky, B Naujoks
1Institut für Anaesthesiologie, Universität Erlangen-Nürnberg.
Insights
Atropine and glycopyrrolate showed no significant differences in preventing oculocardiac reflexes (OCR) or heart rate changes during ophthalmic surgery. Both anticholinergics demonstrated similar safety profiles regarding arrhythmia occurrence and severity in adult patients.
Area of Science:
- Anesthesiology
- Ophthalmology
- Cardiology
Background:
- Anticholinergic medications are crucial for inhibiting oculocardiac reflexes (OCR) during ophthalmic surgery.
- While all anticholinergics can cause arrhythmias, comparative data on atropine versus glycopyrrolate is lacking.
- Understanding the comparative arrhythmic effects of these agents is vital for patient safety.
Purpose of the Study:
- To compare the efficacy and safety of atropine (A) and glycopyrrolate (G) in preventing OCR during ophthalmic surgery.
- To evaluate and compare the occurrence and severity of cardiac arrhythmias induced by equipotent doses of atropine and glycopyrrolate.
- To assess the impact of these anticholinergics on heart rate throughout different phases of ophthalmic procedures.
Main Methods:
- A randomized, double-blind study involving 100 adult patients (ASA class I-II) undergoing ophthalmic surgery.
- Patients received equipotent doses of atropine (10 µg/kg) or glycopyrrolate (5 µg/kg) before anesthesia induction.
- Continuous Holter monitoring was employed to analyze heart rate, OCR frequency, and various arrhythmias across defined surgical phases.
Main Results:
- No significant differences were observed in the frequency of oculocardiac reflexes (OCR) between atropine and glycopyrrolate groups.
- Mean heart rate variations across all surgical phases were comparable between the two anticholinergic treatments.
- The study found no statistically significant differences in the overall occurrence or severity of supraventricular, junctional, or ventricular arrhythmias between atropine and glycopyrrolate.
Conclusions:
- Atropine and glycopyrrolate exhibit similar efficacy in inhibiting oculocardiac reflexes during ophthalmic surgery.
- Both agents demonstrate comparable safety profiles concerning cardiac rhythm disturbances and heart rate modulation in this patient population.
- The choice between atropine and glycopyrrolate may not significantly impact the risk of arrhythmias or OCR in adults undergoing ophthalmic procedures.
Abstract:
Anticholinergics are indicated in ophthalmic surgery to inhibit oculocardiac reflexes (OCR). Although all anticholinergics exert an arrhythmic effect, comparative data on occurrence and severity of arrhythmias are not available. The aim of this investigation was to compare atropine (A) and glycopyrrolate (G) in adults undergoing ophthalmic surgery. One hundred patients (ASA class I and II, age range 20-60 yrs.) were given equipotent doses of either A (10 micrograms.kg-1) or G (5 micrograms.kg-1) in a randomized, double-blind fashion, before induction of anaesthesia. Continuous Holter monitoring was performed. The procedure was divided into the following phases: O (5 min before drug), I (5 min after drug), II (up to induction), III (induction until intubation), IV (intubation until operation), V (operation). Supraventricular, junctional, and ventricular arrhythmias were analyzed. Severe arrhythmia was judged to be greater than 5 events per min, or ventricular beats Lown classes III-V. The beat to beat analog signal was digitalized. The heart rate (HR) and the occurrence rate of OCR (greater than 20% decrease in heart rate, arrhythmias) was calculated by a computerized program. Analysed were: 1. the frequency of OCR, 2. the mean HR for each phase, 3. the frequency of all the various arrhythmias during the whole period, 4. as well as for each phase. The number of patients with severe arrhythmias 5. either for all the time or 6. for the individual phase were registered separately. There were no differences 1. in the frequency of OCR and 2. in mean HR during all phases between A and G.(ABSTRACT TRUNCATED AT 250 WORDS)
Related Concept Videos
01:30Pulse rhythm
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac muscle...
01:25Correlation between ECG and Cardiac Cycle
A cardiac action potential originates in the SA node and spreads throughout the atria and the AV node in approximately 0.03 seconds. This results in the P wave in an ECG and triggers atrial contraction. The action potential is then briefly slowed at the AV node, allowing the atria to contract and fill the ventricles with blood before...
01:29Disturbances in Heart Rhythm
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
01:16ECG Interpretation of Arrhythmias I: Sinus Arrhythmias
Types of Arrhythmias
Sinus Node Arrhythmias
Sinus Bradycardia: Originating from the sinoatrial (SA) node, sinus bradycardia involves slower impulses, resulting in a heart rate of less than 60 beats per minute (bpm). Causes include sleep, vagal stimulation, beta-blockers, hypothyroidism, and...
01:30Dysrhythmias V: Evaluating Dysrhythmias
01:25ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias