Bradycardia during intra-abdominal surgery. Modification by pre-operative anticholinergic agents

The aim of the present study was to examine, in a double-blind, randomised manner, the effects of glycopyrronium 0.005 mg/kg, atropine 0.01 mg/kg or a placebo (normal saline) on the frequency of bradycardia in 92 patients scheduled for major abdominal or gynaecological surgery. All patients received fentanyl, halothane and vecuronium. The frequency of bradycardia in the group that received saline was 18%. No cases occurred in either anticholinergic group. Mean heart rates intra-operatively were not significantly different between the atropine and glycopyrronium groups. It is suggested that the routine use of pre-operative anticholinergic agents should be considered when a similar anaesthetic technique is employed.