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Related Experiment Videos

Anticholinergic premedication for fibreoptic bronchoscopy

C Roffe1, M J Smith, G S Basran

  • 1Respiratory Unit, Rotherham General Hospital, UK.

Monaldi Archives for Chest Disease = Archivio Monaldi Per Le Malattie Del Torace
|April 1, 1994
PubMed
Summary

Glycopyrrolate and atropine were compared for fibreoptic bronchoscopy premedication. Glycopyrrolate improved procedure ease by reducing coughing and movement, while atropine offered slightly better patient comfort.

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Area of Science:

  • Pulmonology
  • Anesthesiology
  • Pharmacology

Background:

  • Anticholinergic agents like atropine are standard for fibreoptic bronchoscopy premedication.
  • Glycopyrrolate is a newer alternative claimed to reduce tachycardia and sedation while enhancing salivation control.

Purpose of the Study:

  • To assess anticholinergic effects on bronchoscopy ease, hemodynamics, and patient comfort.
  • To compare atropine with glycopyrrolate for these outcomes.

Main Methods:

  • 190 patients randomly assigned to diazepam alone, diazepam + atropine, or diazepam + glycopyrrolate.
  • Drugs administered orally (diazepam) or intramuscularly (atropine/glycopyrrolate) before the procedure.
  • Standardized anesthesia and local anesthetic techniques were used for all patients.

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Main Results:

  • Hemodynamic problems during bronchoscopy were similar across all groups.
  • Glycopyrrolate significantly reduced operator-observed coughing and patient movement compared to atropine and control.
  • Patient-reported mouth dryness was highest with glycopyrrolate, but overall discomfort and willingness for repeat procedures were similar across groups.

Conclusions:

  • Glycopyrrolate slightly improved bronchoscopy ease for operators due to better cough and movement suppression.
  • Atropine provided marginally better patient comfort, though overall discomfort levels were comparable.
  • Differences between the anticholinergic agents were minor in this study.