Glycopyrrolate vs. atropine during anaesthesia for laryngoscopy and bronchoscopy

Grønnebech, H.; Johansson, Gun; Smedebøl, M.; Valentin, N.

doi:10.1111/j.1399-6576.1993.tb03745.x

Cited by 19 publications

(10 citation statements)

References 19 publications

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“…Randomized placebo-controlled trials are equivocal regarding the efficacy of atropine 61 and glycopyrrolate [62][63][64][65] to reduce gastric volume or acidity (Category C2 evidence).…”

Section: Preoperative Anticholinergicsmentioning

confidence: 99%

Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients Undergoing Elective Procedures

2011

Anesthesiology

1,071

153

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P RACTICE Guidelines are systematically developed recommendations that assist the practitioner and patient in making decisions about health care. These recommendations may be adopted, modified, or rejected according to clinical needs and constraints and are not intended to replace local institutional policies. In addition, Practice Guidelines developed by the American Society of Anesthesiologists (ASA) are not intended as standards or absolute requirements , and their use cannot guarantee any specific outcome. Practice Guidelines are subject to revision as warranted by the evolution of medical knowledge, technology, and practice. They provide basic recommendations that are supported by a synthesis and analysis of the current literature, expert and practitioner opinion, open forum commentary, and clinical feasibility data. This update includes data published since the Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration were adopted by the ASA in 1998 and published in 1999.* Methodology Definition of Preoperative Fasting and Pulmonary Aspiration For these Guidelines, preoperative fasting is defined as a prescribed period of time before a procedure when patients are not allowed the oral intake of liquids or solids. Perioperative pulmonary aspiration is defined as aspiration of gastric contents occurring after induction of anesthesia, during a procedure, or in the immediate period after surgery. Purposes of the Guidelines The purposes of these Guidelines are to (1) enhance the quality and efficiency of anesthesia care, (2) stimulate evaluation of clinical practices, and (3) reduce the severity of complications related to perioperative pulmonary aspiration of gastric contents. Enhancements in the quality and efficiency of anesthesia care include, but are not limited to, the cost-effective use of perioperative preventive medication, increased patient satisfaction, avoidance of delays and cancellations, decreased risk Updated by the American Society of Anesthesiologists (ASA) Committee on Standards and Practice Parameters, Jeffrey L. Apfelbaum, M.D. (Chair),

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“…Randomized placebo-controlled trials are equivocal regarding the efficacy of atropine 61 and glycopyrrolate [62][63][64][65] to reduce gastric volume or acidity (Category C2 evidence).…”

Section: Preoperative Anticholinergicsmentioning

confidence: 99%

Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients Undergoing Elective Procedures

2011

Anesthesiology

1,071

153

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“…In a survey of Australian anaesthetists, very few used anticholinergic drugs routinely (21). In a study comparing three groups of patients undergoing laryngoscopy and bronchoscopy, those in the placebo group had a lower incidence of cardiac arrhythmia compared with those in the atropine group or the glycopyrrolate group (22).…”

Section: Anticholinergic Agentsmentioning

confidence: 99%

Rigid bronchoscopy for foreign body removal: anaesthesia and ventilation

Farrell

2004

Pediatric Anesthesia

117

101

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Foreign body aspiration is a leading cause of death in children 1-3 years old, although mortality is low for children who reach the hospital. Presenting symptoms of an inhaled foreign body depends on time since aspiration. Immediately after inhalation the child starts to cough, wheeze, or have laboured breathing. If the early signs are missed, the child usually presents with fever and other signs and symptoms of chest infection. A plain chest X-ray has relatively low sensitivity and specificity for inhaled foreign body. The gold standard for diagnosis and management of this condition is rigid open tube bronchoscopy under general anaesthesia. For late presentations, time should be taken to fast the child and complete a thorough evaluation before bronchoscopy. The procedure should be performed in a well-equipped room with at least two anaesthesiologists, one with paediatric experience, in attendance. Most experienced anaesthesiologists prefer inhalational rather than intravenous induction of anaesthesia and a ventilating bronchoscope rather than intubation. Equally good results have been reported with spontaneous ventilation or positive pressure ventilation; jet ventilation is not advocated for foreign body removal in children.

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“…48 Premedication with small intramuscular doses of glycopyrrolate (0.005 mg·kg −1 ) 30 min prior to procedure is commonly seen in clinical practice. 100,101 Atropine use is discouraged as it has been associated with greater hemodynamic fluctuations and increased procedure time, 48 though available data on this subject are limited.…”

Section: Anesthetic Depth and Pharmacologic Considerationsmentioning

confidence: 99%

Anesthesia for interventional pulmonology procedures: a review of advanced diagnostic and therapeutic bronchoscopy

Lima

Kheir

Majid

et al. 2018

Can J Anesth/J Can Anesth

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Glycopyrrolate vs. atropine during anaesthesia for laryngoscopy and bronchoscopy

Cited by 19 publications

References 19 publications

Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients Undergoing Elective Procedures

Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients Undergoing Elective Procedures

Rigid bronchoscopy for foreign body removal: anaesthesia and ventilation

Anesthesia for interventional pulmonology procedures: a review of advanced diagnostic and therapeutic bronchoscopy

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