A PLACEBO-CONTROLLED TRIAL USING INTRAVENOUS ATROPINE AS AN ADJUNCT TO CONSCIOUS SEDATION IN PEDIATRIC ESOPHAGOGASTRODUODENOSCOPY

Background: The usefulness of intravenous atropine as an adjunct to co nscious sedation in pediatric esophagogastroduodenoscopy remains an un resolved issue. Methods: This prospective, double-blind, randomized st udy examined 101 patients, who were randomized to receive either intra venous atropine 0.02 mg/kg (maximum 0.4 mg) or a placebo of normal sal ine solution prior to the procedure. Results: The mean maximum heart r ate during the procedure and the percentage of time that the heart rat e was more than 1 standard deviation above mean for age was significan tly greater in the atropine group as compared to the placebo group (p < 0.0005). There was no significant difference between groups in the a mount of secretions noted, gastric motility, retching or vomiting, fac ial flushing, or dysphoria. There were no cases of significant bradyca rdia or hypotension in either group. There was a significant number of patients greater than 5 years of age and receiving meperidine and atr opine (as compared with meperidine and placebo) whose arterial oxygen saturation dropped below 90% during the procedure (p = 0.0485). Conclu sions: We found that the use of atropine when used as an adjunct to co nscious sedation in children undergoing upper endoscopy did not increa se the safety of the procedure or provide significant benefits. We do not recommend the routine use of atropine for upper endoscopy in pedia tric patients.