Key result
Prophylactic intravenous glycopyrrolate maintained significantly higher mean arterial pressure (79.6 vs 76.63, p=0.029) and heart rate at 15 minutes compared to atropine during spinal anesthesia for cesarean section.
Why the study?
The study was conducted to compare the efficacy of atropine and glycopyrrolate in reducing the risk of spinal anesthesia-induced hypotension in patients undergoing caesarean sections.
Does prophylactic intravenous atropine compared to glycopyrrolate prevent spinal-induced hypotension in pregnant women undergoing elective C-section?
RCT (n=332)
Double-blind
Computer-generated randomization tables
No
Does prophylactic intravenous atropine compared to glycopyrrolate prevent spinal-induced hypotension in pregnant women undergoing elective C-section?
Absolute Event Rate: 79.6% vs 76.63%
p-value: p=0.029
Prophylactic intravenous glycopyrrolate provides better hemodynamic stability at 15 minutes compared to atropine in patients undergoing elective C-section under spinal anesthesia.
Glycopyrrolate may reduce vasopressor needs versus atropine before cesarean spinal anesthesia; extends comparative RCT data on anticholinergic prophylaxis.
Objective: The purpose of this study is to compare the efficacy of atropine and glycopyrrolate in reducing the risk of hypotension caused by spinal anesthesia in patients undergoing caesarean sections. Methods: After ethical approval from institution review board, this randomized control was carried out at Liaqat national hospital and medical college. 332 pregnant women in a row who had chosen to have a caesarean section were enlisted through non-probability consecutive sampling technique. Subjects were randomly assigned to one of two groups of 166 using computer-generated randomization tables. Group A Patients received intravenous atropine in dose of 0.01mg/kg before inducing spinal anesthesia. Group B Patients received intravenous glycopyrrolate in dose of 0.01mg/kg before inducing spinal anesthesia. Pre-surgical, operational, and post-operative treatment for all patients was adhered to the same established protocols. Results: The mean age of the participants in both study groups were 26.28±4.03 and 26.07±3.78 years. The mean weight of the participants in both study groups were 75.24±7.6 and 74.17±7.54 Kg. The mean gestation age of the participants in both study groups were 38.82±1.17 and 38.70±1.19 months. The heart rate (HR) 15-minutes after the administration of atropine in group A was 94.89±11.8, and in Group B after administration of glycopyrrolate was 98.18±11.5. A significant difference (P=0.045) in the mean HR of the participants in both study groups was observed. The Mean Arterial Pressure (MAP) 15-minutes after the administration of atropine in group A was 76.63±7.9, and in Group B after administration of glycopyrrolate was 79.6±10.5. A significant difference (P=0. 0.029) in the mean MAP of the participants in both study groups was observed. Conclusion: Glycopylorate, atropine, spinal anesthesia, hypotension, heart rate
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Khalid et al. (2023) conducted an RCT in Spinal-induced hypotension during cesarean section (n=332). Glycopyrrolate vs. Atropine (0.01 mg/kg IV) was evaluated on Mean Arterial Pressure (MAP) at 15 minutes (p=0.029). Prophylactic intravenous glycopyrrolate maintained significantly higher mean arterial pressure (79.6 vs 76.63, p=0.029) and heart rate at 15 minutes compared to atropine during spinal anesthesia for cesarean section.
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