[Effects of atropine in coronary heart disease]

For the detection of atropine effects the hemodynamic changes of 50 patients with coronary heart disease being premedicated intramuscularly with pethidine/diazepam have been registered 3 and 6 minutes after intravenous atropine application (0.01 mg/kg). All patients showed an increase of the heart rate, but only 80% demonstrated an increase of cardiac index at the same time. 20% of these patients exhibited a decrease of the stroke volume, whereas in 5 cases out of this group the patients complained ischemic pain. In a second part of this investigation the results of an induction of neuroleptanalgesia have been compared with another group of 50 patients with the same disease. The function of the right and left ventricle was significantly depressed in the patients with atropine application before the induction of anaesthesia. The results are discussed as an important argument against the routine use of atropine for premedication purposes.