■格隆溴铵通常作为术前药物或与胆碱酯酶抑制剂联合研究,以抵消非去极化毒蕈碱药物的毒蕈碱作用。然而,关于格隆溴铵优于其他抗胆碱能药物的研究结果不一致,比如阿托品,尤其是它对心率的影响,血压(BP),和腺体分泌物.这项研究旨在评估围手术期口腔分泌物的差异,血流动力学,在接受扁桃体切除术和腺样体切除术的儿童中,格隆溴铵与阿托品在麻醉诱导前的恢复质量。
■在这个前景中,单中心,随机化,双盲,对照试验,共有103名儿童被随机分为A组(n=51,格隆溴铵0.005mg/kg)或B组(n=52,阿托品0.01mg/kg).两组的后续麻醉诱导和维持方案相同。生命体征,手术持续时间,拔管时间,气管插管时声带周围的湿度,口腔分泌物的重量,记录围手术期并发症。
■在气管插管期间,在声带周围的湿润程度上没有观察到显着差异,以及口腔分泌物的重量,手术持续时间,或者拔管时间,两组之间。A组术中、术后心率低于B组(110.18±10.58vs.114.94±11.14,p=0.028;96.96±10.81vs.103.38±10.09,p=0.002)。A组术中和术前心率的差异低于B组(23.84±9.62vs.29.65±8.75,p=0.002)。A组术后和术前心率的差异低于B组(10.63±9.97vs.18.09±9.39,p=0.000)。
■在扁桃体切除术和腺样体切除术期间和之后,格隆溴铵的心率变化比阿托品更平稳,对BP或回收质量没有影响,并且没有增加口腔分泌物。研究结果表明,格隆溴铵可以作为阿托品的替代品,以防止小儿扁桃体切除术和腺样体切除术麻醉诱导中的分泌物。试验注册:本研究在中国临床试验注册中心注册(注册编号:ChiCTR2200063578;注册日期:12/09/2022)。
UNASSIGNED: Glycopyrrolate is commonly researched as a preoperative medication or in conjunction with cholinesterase inhibitors to counteract the lingering muscarinic effects of non-depolarizing muscarinic agents. However, studies have yielded inconsistent results regarding the superiority of glycopyrrolate over other anti-cholinergic drugs, such as atropine, particularly its effect on heart rate, blood pressure (BP), and glandular secretions. This
study aimed to evaluate the differences in perioperative oral secretions, hemodynamics, and recovery quality with glycopyrrolate versus those with atropine before anesthesia induction in children undergoing tonsillectomy and adenoidectomy.
UNASSIGNED: In this prospective, single-center, randomized, double-blind, controlled
trial, a total of 103 children were randomly assigned to group A (n = 51, glycopyrrolate 0.005 mg/kg) or B (n = 52, atropine 0.01 mg/kg). The follow-up anesthetic induction and maintenance protocols were the same in both groups. Vital signs, duration of surgery, extubation time, degree of wetness around the vocal cords during tracheal intubation, weight of oral secretions, and perioperative complications were recorded.
UNASSIGNED: No significant differences were observed in the degree of wetness around the vocal cords during tracheal intubation, as well as in the weight of oral secretions, duration of surgery, or extubation time, between the two groups. The intraoperative and postoperative heart rates were lower in group A than in group B (110.18 ± 10.58 vs. 114.94 ± 11.14, p = 0.028; 96.96 ± 10.81 vs. 103.38 ± 10.09, p = 0.002). The differences observed in the intraoperative and preoperative heart rates were lower in group A than in group B (23.84 ± 9.62 vs. 29.65 ± 8.75, p = 0.002). The differences observed in the postoperative and preoperative heart rates were lower in group A than in group B (10.63 ± 9.97 vs. 18.09 ± 9.39, p = 0.000).
UNASSIGNED: Glycopyrrolate showed a smoother change in heart rate than atropine during and after tonsillectomy and
adenoidectomy, with no effect on BP or recovery quality, and did not increase oral secretions. The findings indicate that glycopyrrolate can serve as an alternative to atropine to prevent secretions in anesthesia induction for tonsillectomy and
adenoidectomy in children.
Trial registration: This
study was registered with the Chinese Clinical
Trial Registry (Registration Number: ChiCTR2200063578; Date of Registration: 12/09/2022).