Chest
BronchoscopyThe Role of Anticholinergics in Bronchoscopy: A Randomized Clinical Trial
Section snippets
Materials and Methods
A total of 217 patients undergoing elective outpatient fiberoptic bronchoscopy participated in this prospective, placebo-controlled, double-blind study after providing informed written consent and after approval by the Institutional Review Board for ethical research. Patients were randomly assigned to receive atropine, 0.01 mg/kg body weight; glycopyrrolate, 0.005 mg/kg; or saline solution placebo, approximately 2 mL. All agents were administered IM, 15 to 45 min prior to the procedure.
Study
Results
The characteristics of each patient group were similar in terms of age and gender (Table 1). Equivalent doses of medications were utilized, and there was no appreciable difference in the time required to complete the bronchoscopy for each subgroup of patients. Indications for bronchoscopy and procedures performed during bronchoscopy are given in Table 2.
Five bronchoscopies (2.3% of the total) required early termination of the procedure: atropine (n = 2), glycopyrrolate (n = 1), and placebo (n =
Discussion
The use of anticholinergic agents to prevent reflex bronchoconstriction and bradycardia, reduce secretions, and minimize cough has been commonly employed by bronchoscopists throughout North America.1 As with all IM medication delivery, the use of these agents adds a certain amount of patient discomfort, a small but present overall risk, and, when summed over many patients, a significant increase in cost. Unfortunately, studies designed to examine the safety and efficacy of these drugs are
ACKNOWLEDGMENT
We wish to thank the nurses of the Mayo Medical Center, Department of Surgical Services, for their assistance in administering the patient visual analog surveys. We also wish to acknowledge Darrell R. Schroeder, Mayo Medical Center, Department of Health Sciences Research, for assistance with statistical analysis.
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Anesthesia
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Supported by a clinical trial grant from Glaxo Wellcome, Research Triangle Park, NC.