Abstract
This study was conducted to compare the haemodynamic effects and clinical effectiveness of Atropine versus Glycopyrrolate along with Neostigmine for reversing non-depolarizing neuromuscular blocking agents (NMBAs) in patients with elective surgery under general anaesthetic. There were 110 adult patients of ASA physical status I-II who were enrolled and divided into two groups: Group A (Atropine + Neostigmine, n=60) and Group B (Glycopyrrolate + Neostigmine, n=50). Data was obtained using a structured Performa and was analysed using SPSS version 25.0. The 2 groups had no statistically significant difference in baseline demographic and physiological parameters such as age, heart rate and ASA classification (p>0.05) and therefore successful group allocation was achieved. There was effective control of secretions and complete prevention of bradycardia in both groups with no bradycardia occurring in either group. There was a highly significant difference between the two groups with 40 patients (66.7%) having tachycardia in the Atropine + Neostigmine group and none (0%) in the Glycopyrrolate + Neostigmine group (p 0.001, χ² = 52.381, df = 1). These results show that both agents prevent bradycardia equally well and control secretions equally well, but that Glycopyrrolate has a markedly more favourable cardiovascular safety profile, with no risk of tachycardia. Use of Glycopyrrolate and Neostigmine is shown to be a more hemodynamically stable alternative for the reversal of neuromuscular blockade than the use of Atropine and should be preferred in clinical anesthetic practice, especially in patients at cardiovascular risk.