[Bronchoscopy and rhythmic disorders. Premedication with atropine-sulfate, as a rule?]

Area of Science:

• Pulmonology
• Cardiology
• Anesthesiology

Background:

• Flexible bronchoscopy is a vital diagnostic and therapeutic tool in modern medicine.
• Atropine is often used as a premedication for flexible bronchoscopy, believed to offer cardioprotection and reduce mucus secretion.
• However, controlled studies to validate these assumptions are lacking.

Purpose of the Study:

• To investigate the efficacy of atropine as a premedication in flexible bronchoscopy.
• To assess the impact of atropine on cardiac rhythm and mucus secretion during the procedure.

Main Methods:

• A randomized controlled trial involving 55 patients undergoing flexible bronchoscopy.
• Patients were divided into two groups: one receiving atropine premedication and the other not.
• Cardiac activity was monitored using Holter ECG for 24 hours, and endobronchial mucus secretion was semiquantitatively assessed.

Main Results:

• No significant differences were observed in the incidence of bradycardia or heart rhythm alterations between the atropine and placebo groups.
• Mucus secretion levels and procedure duration also showed no statistically significant variations between the groups.
• Cardiac monitoring revealed no relevant arrhythmias or adverse cardiac events in either group.

Conclusions:

• Premedication with atropine is not essential for flexible bronchoscopy performed under local anesthesia.
• Flexible bronchoscopy can be safely conducted without atropine, demonstrating a low impact on patients and minimal risk of inducing arrhythmias.
• These findings suggest that routine atropine administration may not be justified for this procedure.