Oral atropine enhances the risk for acid aspiration in children

Two modes of administration of an anticholinergic drug were compared in 58 healthy children undergoing adenoidectomy. The study was double-blind and randomized. All children were premedicated with oral midazolam 0.5 mg/kg. Twenty-nine children received oral atropine 0.03 mg/kg (Group A) and the rest were given i.v. glycopyrrolate 0.005 mg/kg at the induction of anaesthesia (Group G). In Group A, of 29 children, the stomach was empty in 2, pH was less than 2.5 in 23, the gastric volume was greater than 0.4 ml/kg in 19, and both these risk factors were present in 17 children. The same figures in Group G were 5 (NS), 14 (P less than 0.05), 10 (P less than 0.05) and 9 (P less than 0.05) children, respectively. The antisialagogue effect was similar in both groups.