Key result
Glycopyrrolate resulted in a significantly lower intraoperative heart rate (115.19 vs 120.10 beats/min) and smoother heart rate changes compared to atropine in children undergoing tonsillectomy and adenoidectomy, with no difference in oral secretions.
Why the study?
To compare the effects of glycopyrrolate and atropine before anesthesia induction on perioperative oral secretions, hemodynamics, and recovery quality in children undergoing tonsillectomy and adenoidectomy.
Does glycopyrrolate improve perioperative hemodynamics and reduce oral secretions compared to atropine in children undergoing tonsillectomy and adenoidectomy?
RCT (n=103)
Double-blind
Random number list
No
Does glycopyrrolate improve perioperative hemodynamics and reduce oral secretions compared to atropine in children undergoing tonsillectomy and adenoidectomy?
Absolute Event Rate: 115.19% vs 120.1%
p-value: p=0.033
Glycopyrrolate provides smoother heart rate control with less volatility compared to atropine during induction of anesthesia for pediatric tonsillectomy and adenoidectomy, without affecting blood pressure or increasing oral secretions.
Glycopyrrolate yields smoother heart rate changes than atropine with equivalent antisialagogue effects; leaves open routine preference in pediatric tonsillectomy induction.
Purpose To compare the effects of glycopyrrolate and atropine before induction of anesthesia on perioperative oral secretions, hemodynamics and recovery quality of tonsillectomy and adenoidectomy in children. Methods A total of 103 children were randomly divided into group A (glycopyrrolate, n = 51) and group B (atropine, n = 52). In Group A, glycopyrrolate 0.005mg/kg was injected intravenously before anesthesia induction. In Group B, atropine 0.01mg/kg was injected intravenously before anesthesia induction. The rest of the induction intubation and anesthesia maintenance protocol were the same. The vital signs of the children at each time points were recorded after they entered the operating room. The duration of operation, the duration of extubation, the weight of oral secretions, and the perioperative complications were recorded. Results There were no statistically significant differences in operation duration, extubation duration and oral secretion weight between the two groups. The intraoperative and postoperative heart rate was lower in Group A (glycopyrrolate) than in Group B (atropine) (115.19 ± 11.41 vs 120.10 ± 11.62, p = 0.033; 96.96 ± 10.81 vs 103.38 ± 10.09, p = 0.002). The amount of intraoperative and postoperative heart rate change was lower in Group A (glycopyrrolate) than in Group B (atropine) (28.86 ± 10.42 vs 34.81 ± 10.22, p = 0.004; 10.63 ± 9.97 vs 18.09 ± 9.39, p = 0.000). The incidence of perioperative complications did not differ between the two groups. Conclusions Compared to atropine, glycopyrrolate is more suitable for induction of anesthesia for paediatric tonsil and adenoid surgery as it has smoother heart rate changes with less volatility and does not affect blood pressure or postoperative arousal, nor does it increase oral secretions. Trial registration Chinese Clinical Trial Registry:(Registration number: ChiCTR2200063578); Date of Registration:12/09/2022
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Tao et al. (2023) conducted an RCT in Tonsillectomy and adenoidectomy (n=103). Glycopyrrolate vs. Atropine 0.01mg/kg IV was evaluated on Intraoperative heart rate (beats/min) (p=0.033). Glycopyrrolate resulted in a significantly lower intraoperative heart rate (115.19 vs 120.10 beats/min) and smoother heart rate changes compared to atropine in children undergoing tonsillectomy and adenoidectomy, with no difference in oral secretions.
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