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Tracheal administration of atropine in children--effect on heart rate
1Department of Anaesthesiology, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
Insights
Tracheal atropine in children undergoing surgery did not significantly increase heart rate. This method is considered insufficient for emergency use due to its slow and moderate effects.
Area of Science:
- Anesthesiology
- Pediatric Anesthesia
- Pharmacology
Background:
- Tracheal drug administration is an alternative route for emergency medications.
- Atropine is used to manage bradycardia during anesthesia.
Purpose of the Study:
- To evaluate the efficacy of tracheally administered atropine in pediatric patients.
- To assess the impact of tracheal atropine on heart rate in children.
Main Methods:
- Double-blind, randomized study.
- 41 pediatric patients (2-6 years) received either atropine (0.02 mg.kg-1) or saline via trachea.
- Heart rate was monitored for changes.
Main Results:
- Atropine group showed a heart rate increase of 8.8 beats.min-1 (8.7%) at 3 minutes and 16.2 beats.min-1 (16.0%) at 5 minutes.
- No significant heart rate increase was observed in the saline group.
- The onset of action was delayed, and the heart rate increase was moderate.
Conclusions:
- Tracheal atropine administration at 0.02 mg.kg-1 in children has a slow onset and moderate effect on heart rate.
- This route and dosage are insufficient for managing emergencies in pediatric anesthesia.
- Alternative methods or dosages may be required for emergency bradycardia treatment in children.
Abstract:
Forty-one ASA I patients, aged 2-6 years, anaesthetized for elective ear, nose and throat surgery, were studied in a double blind and randomized fashion in order to examine the effect of tracheally administered atropine 0.02 mg.kg-1 or saline 0.9% on heart rate. In patients receiving atropine heart rate increased 8.8 beats.min-1 (8.7%) and 16.2 beats.min-1 (16.0%) after 3 and 5 min respectively. No increase in heart rate was seen in the saline group. Because of the late onset of action and only moderate increase in heart rate it is concluded that tracheal administration of atropine 0.02 mg.kg-1 to children is insufficient in emergency situations.