It is not necessary to administer more than 10 micrograms.kg-1 of atropine to older children before succinylcholine.

Abstract

It is common practice at the Hospital for Sick Children, Toronto, to administer atropine 20 micrograms.kg-1 prior to succinylcholine in infants and children. It is unclear whether "prophylactic" administration of this dose of atropine to older children (6-16 yr) is necessary. This study was designed to compare the changes in heart rate, rhythm and mean arterial pressure after administration of either atropine 10 or 20 micrograms.kg-1 with succinylcholine or vecuronium (control group) to older children anaesthetized with thiopentone. Thirty-six ASA I or II patients (6-16 yr) were studied. Anaesthesia was induced with thiopentone 5 mg.kg-1. Patients were randomly assigned to receive: (a) atropine 10 micrograms.kg-1 and succinylcholine 1.5 mg.kg-1 (n = 12), (b) atropine 20 micrograms.kg-1 and succinylcholine 1.5 mg.kg-1 (n = 13) or (c) vecuronium 0.1 mg.kg-1 (n = 11) to facilitate tracheal intubation. Heart rate and rhythm were recorded continuously using a computerised analogue interface whereas blood pressure was monitored non-invasively before induction of anaesthesia, immediately before and at one and three minutes after laryngoscopy. No difference was observed between patients who received atropine 10 or 20 micrograms.kg-1 prior to succinylcholine. No episode of sinus bradycardia occurred. Premature atrial contractions were observed in two patients (one succinylcholine/atropine 20 micrograms.kg-1, one vecuronium). Administration of atropine 20 micrograms.kg-1 prior to succinylcholine provides no advantage over atropine 10 micrograms.kg-1 in older children in terms of cardiovascular stability.

• Authors: G D Shorten, B Bissonnette, E Hartley, W Nelson, A S Carr
• Journal: Canadian journal of anaesthesia = Journal canadien d'anesthesie (Can J Anaesth) Vol. 42 Issue 1 Pg. 8-11 (Jan 1995) ISSN: 0832-610X [Print] United States
• PMID: 7534217 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Atropine
• Vecuronium Bromide
• Succinylcholine
• Thiopental

Topics

• Adolescent
• Anesthesia, Intravenous
• Arrhythmia, Sinus (chemically induced)
• Atrial Function (drug effects)
• Atropine (administration & dosage, pharmacology)
• Blood Pressure (drug effects)
• Bradycardia (chemically induced)
• Cardiac Complexes, Premature (chemically induced)
• Child
• Female
• Heart Rate (drug effects)
• Humans
• Infant
• Intubation, Intratracheal
• Laryngoscopy
• Male
• Succinylcholine (administration & dosage, pharmacology)
• Thiopental (administration & dosage)
• Vecuronium Bromide (administration & dosage, pharmacology)