Comparison of gallamine and atropine as pretreatment before anesthetic induction and succinylcholine administration

Heart-rate changes following pretreatment with IV gallamine 0.3 mg/kg (40 patients) or atropine 0.006 mg/kg (40 patients) and the incidence of heart-rate slowing and/or junctional rhythm after thiamylal anesthetic induction and 2 injections of succinylcholine (SCh) were determined in adult patients. Awake heart rate increased 13 and 16 bpm (p less than 0.05) 1 and 3 minutes after gallamine. In contrast, heart rate was unchanged 1 minute after atropine and then was increased about 10 bpm (p less than 0.05) 3 minutes later. Heart-rate slowing (greater than 15% as compared with the rate immediately before SCh) and junctional rhythm occurred in 1 patient from each group following the 1st SCh dose. Heart-rate slowing after the 2nd SCh injection occurred in 1 patient pretreated with gallamine and in 14 patients pretreated with atropine. Junctional rhythm did not occur in any patient after the 2nd SCh dose. The authors conclude that IV gallamine is more effective than atropine in preventing heart-rate slowing after repeated SCh administration.