title: Comparison of the incidence of complications at induction and emergence in infants receiving oral atropine vs no premedication.
abstract: We studied 120 patients less than 1 yr of age, allocated randomly to receive atropine 40 micrograms kg-1 orally 1 h before operation (group A) or no premedication (group B). All patients underwent a standardized anaesthetic, including inhalation induction with halothane followed by atracurium 0.5 mg kg-1, tracheal intubation and positive pressure ventilation. Monitoring during anaesthesia included heart rate, arterial oxygen saturation, temperature and airway conditions at induction and emergence. The incidence of a decrease in arterial oxygen saturation to 94% or less at induction and recovery was similar in both groups (30.5% at induction, 39% at extubation in group A; 31% at induction, 41% at extubation in group B). There were significantly more airway complications in group B both at induction and emergence (25% and 49%, respectively, compared with 9% and 25% in group A; P < 0.015). Mean heart rate at induction and in the peroperative period was significantly higher in the group receiving atropine (P < or = 0.001). There was an increased incidence of bradycardia (decrease in heart rate of > or = 20%) at induction in the non-premedicated group (23% in group B compared with 10% in group A), but this was not statistically significant. We conclude that the incidence of airway complications at induction and emergence was reduced by orally administered atropine premedication.
authors.affiliation: Department of Anaesthesia, Great Ormond Street Hospital for Children NHS Trust, London, UK.
authors.forename: C A
authors.initials: CA
authors.lastname: Shaw
authors.forename: A A
authors.initials: AA
authors.lastname: Kelleher
authors.forename: C P
authors.initials: CP
authors.lastname: Gill
authors.forename: L J
authors.initials: LJ
authors.lastname: Murdoch
authors.forename: R H
authors.initials: RH
authors.lastname: Stables
authors.forename: A E
authors.initials: AE
authors.lastname: Black
mesh_terms: D000762:Anesthesia Recovery Period; D000769:Anesthesia, Inhalation; D001285:Atropine / Q000627:therapeutic use*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007431:Intraoperative Complications / Q000517:prevention & control*; D008297:Male; D018727:Muscarinic Antagonists / Q000627:therapeutic use*; D010100:Oxygen / Q000097:blood; D010313:Partial Pressure; D011229:Preanesthetic Medication; D012120:Respiration Disorders / Q000517:prevention & control
chemical_list: D018727:Muscarinic Antagonists; D001285:Atropine; D010100:Oxygen