Effect of pre-treatment with intravenous atropine or glycopyrrolate on cardiac arrhythmias during halothane anaesthesia for adenoidectomy in children |
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Authors: | Annila P; Rorarius M; Reinikainen P; Oikkonen M; Baer G |
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Institution: | University of Tampere, Medical School, P.O. Box 607, 33101 Tampere, Finland; Department of Anaesthesiology, Tampere University Hospital, Finland; Department of Clinical Physiology, Tampere University Hospital, Finland |
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Abstract: | We studied the effect of anticholinergics on the incidence of cardiac
arrhythmias during paediatric anaesthesia. ASA I-II children (n = 77)
undergoing adenoidectomy were randomly allocated to three groups.
Intravenous atropine 0.02 mg kg-1 was given in group A (n = 25),
glycopyrrolate 0.004 mg kg-1 in group G (n = 27) and physiological saline
in group P (n = 25) 3 min before the induction of anaesthesia. The children
breathed spontaneously under halothane anaesthesia with 66% nitrous oxide
in oxygen after induction with thiopentone and succinylcholine.
Perioperative monitoring of the ECG (Holter recordings) and oxygen
saturation was carried out. Ventricular tachycardia occurred in 16.0%,
18.5% and 12.0% of the children in groups A, G and P respectively (ns). The
incidence of ventricular arrhythmias (ventricular tachycardia, ventricular
bigeminy, ventricular premature beats > 10) was 20.0% in group A, 44.4%
in group G and 36.0% in group P (ns). Bradycardia (< 70 beats min-1) was
observed in 0.0%, 14.8% and 24.0% of patients in groups A, G and P
respectively (A vs P, P < 0.05). The use of anticholinergics did not
influence the incidence of ventricular arrhythmias during halothane
anaesthesia in children. Bradycardia was more common in the placebo group
than in the atropine group.
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