Glycopyrrolate Premedication and Procedure-Related Events in Pediatric Upper Endoscopy

Area of Science:

• Pediatric Gastroenterology
• Anesthesiology
• Clinical Pharmacology

Background:

• Glycopyrrolate is used for pediatric upper endoscopy, but evidence for its effectiveness is limited.
• The study addresses the need for clinical data on glycopyrrolate's role in pediatric procedural safety.

Purpose of the Study:

• To determine if glycopyrrolate premedication is associated with a reduced incidence of procedure-related events and serious adverse events (SAEs) in pediatric upper endoscopy.
• To analyze the safety and efficacy of glycopyrrolate in this specific patient population.

Main Methods:

• Retrospective analysis of 1046 pediatric upper endoscopy procedures from the Pediatric Sedation Research Consortium registry (April 2020 - February 2022).
• Primary outcome: incidence of any procedure-related events. Secondary outcome: incidence of SAEs.
• Multivariable analysis was used to assess the association between glycopyrrolate use and outcomes, controlling for patient and procedural factors.

Main Results:

• The overall event rate was 15%, with 3% of patients experiencing SAEs.
• Glycopyrrolate was not significantly associated with the overall event rate (OR: 1.08; 95% CI: 0.72, 1.61).
• Glycopyrrolate use was associated with significantly lower odds of SAEs (OR: 0.34; 95% CI: 0.13, 0.91).

Conclusions:

• Glycopyrrolate premedication may reduce the risk of serious adverse events during pediatric upper endoscopy.
• While the study suggests a potential benefit in reducing SAEs, prospective trials are necessary to validate these findings.
• Further research is recommended to support the routine clinical use of glycopyrrolate for this indication.