A placebo-controlled trial using intravenous atropine as an adjunct to conscious sedation in pediatric esophagogastroduodenoscopy.
BACKGROUND
The usefulness of intravenous atropine as an adjunct to conscious sedation in pediatric esophagogastroduodenoscopy remains an unresolved issue.


METHODS
This prospective, double-blind, randomized study examined 101 patients, who were randomized to receive either intravenous atropine 0.02 mg/kg (maximum 0.4 mg) or a placebo of normal saline solution prior to the procedure.


RESULTS
The mean maximum heart rate during the procedure and the percentage of time that the heart rate was more than 1 standard deviation above mean for age was significantly greater in the atropine group as compared to the placebo group (p < 0.0005). There was no significant difference between groups in the amount of secretions noted, gastric motility, retching or vomiting, facial flushing, or dysphoria. There were no causes of significant bradycardia or hypotension in either group. There was a significant number of patients greater than 5 years of age and receiving meperidine and atropine (as compared with meperidine and placebo) whose arterial oxygen saturation dropped below 90% during the procedure (p = 0.0485).


CONCLUSIONS
We found that the use of atropine when used as an adjunct to conscious sedation in children undergoing upper endoscopy did not increase the safety of the procedure or provide significant benefits. We do not recommend the routine use of atropine for upper endoscopy in pediatric patients.
Hofley
M A
MA
Department of Anesthesia and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania 19104, USA.
Hofley
P M
PM
Keon
T P
TP
Gallagher
P R
PR
Poon
C
C
Liacouras
C A
CA
D000759:Adjuvants, Anesthesia / Q000008:administration & dosage*; D001285:Atropine / Q000008:administration & dosage*; D002648:Child; D016292:Procedural Sedation; D004311:Double-Blind Method; D016145:Endoscopy, Digestive System / Q000379:methods; D006801:Humans; D007275:Injections, Intravenous; D011229:Preanesthetic Medication; D011446:Prospective Studies
D000759:Adjuvants, Anesthesia; D001285:Atropine