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The cardiovascular effects of anticholinergic agents administered during halothane anaesthesia in children
Author(s) -
Badgwell J. M.,
Heavner J. E.,
Cooper M. W.,
Cookings E.
Publication year - 1988
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1988.tb02750.x
Subject(s) - medicine , halothane , anticholinergic , anesthesia , junctional rhythm , atropine , anticholinergic agents , glycopyrrolate , intubation
The cardiovascular effects of anticholinergic agents administered during halothane anaesthesia were studied in 31 children aged 1–12 years undergoing peripheral orthopaedic surgery. Either normal saline, glycopyrro–late (10 μg–kg ‐1 ) or atropine (20 μg–kg ‐1 ) was administered in randomized double–blind fashion during the induction of anaesthesia with halothane while the electrocardiogram was continuously recorded. After induction, the children were paralyzed with atracurium, intubated, and ventilated. Anaesthesia was maintained with N 2 O/O 2 and halothane (up to 2.5% inspired). The concentrations of expired CO 2 and halothane were measured continuously using mass spectrometry. Sixty–one percent (19/31) of the children developed one or more dysrhythmias. Junctional rhythm occurred in 74% (14/19) of the children with dysrhythmias, developed early during induction (mean ± s.d. time = 2.29 ± 2.0 min after commencement of induction), and usually resolved before the administration of the study drug (8/14). All dysrhythmias initially occurred before or during induction and none developed during intubation, during incision, during the maintenance of anaesthesia, or after the administration of anticholinergic agents. The data suggest that: 1) a combination of factors present during halothane induction is highly dysrhythmogenic especially for junctional rhythm; 2) junctional rhythm will resolve spontaneously; 3) the administration of an anticholinergic agent during halothane induction is safe but may be unnecessary in children > 1 year of age; and 4) the dysrhythmogenic factors present during induction are attenuated during the maintenance of halothane anaesthesia.