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A prospective study of atropine premedication in flexible bronchoscopy
Author(s) -
Hewer R. D.,
Jones P. M.,
Thomas P. S.,
Mckenzie D. K.
Publication year - 2000
Publication title -
australian and new zealand journal of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 0004-8291
DOI - 10.1111/j.1445-5994.2000.tb02053.x
Subject(s) - medicine , premedication , atropine , anesthesia , bronchoscopy , pethidine , saline , spirometry , visual analogue scale , sedation , surgery , asthma , analgesic
Aim : This study aimed to assess the effect of atropine premedication prior to flexible bronchoscopy. The rationale for using atropine is that it will dry secretions and allow a better view of the bronchial tree. There is also the theoretical benefit of protection against vasovagal episodes and bronchospasm. Methods : Twenty patients were randomised in a double‐blind manner to receive either 500 meg of atropine intramuscularly or 1 mL of 0.9% saline intramuscularly 30 minutes prior to bronchoscopy. Both groups received a standard dose of intramuscular pethidine. Variables studied included a pre‐procedure electrocardiograph, a rhythm strip during the procedure, serial measurements of blood pressure, continuous pulse oximetry, and spirometry pre‐ and post‐bronchoscopy. Subjective measures recorded were a secretion score, rated 0–3 by the bronchoscopist using a four point visual analogue scale. A patient questionnaire was designed to establish the presence or absence of symptoms, including those related to atropine. Results : There were no significant differences recorded in the duration of procedure, percentage fall in FEV 1 , secretion scores, or other physiological measures. The only significant difference between the two groups was dry mouth in the atropine group ( p <0.001). There was a fall in forced vital capacity from baseline which was significant in the saline group ( p <0.005), and not the atropine group, but it was not significant when compared between groups. A ß 2 adrenergic agonist would, however, be more appropriate to prevent such a fall in spirometry. Conclusions : These results fail to demonstrate a benefit of intramuscular atropine as premedication for fibreoptic bronchoscopy.