Effects of glycopyrrolate and atropine on oral secretions and perioperative hemodynamics in children with tonsillectomy and adenoidectomy: a prospective, single-center, randomized, double-blind, controlled study

Abstract

Abstract 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