PREOPERATIVE GLYCOPYRROLATE - ORAL, INTRAMUSCULAR, OR INTRAVENOUS ADMINISTRATION

Study Objective: To evaluate the effects of oral, intramuscular (IM) a nd intravenous (IV) glycopyrrolate on oral and gastric secretions, and to assess how these routes of administration change intubating condit ions. Design: Randomized, double-blinded study. Setting: University ho spital operating room Patients: 37 ASA status I and II general anesthe sia patients Interventions: Patients were randomized to receive glycop yrrolate or placebo just before surgery by three routes: oral, IM, and IV. Glycopyrrolate was received once by one route and placebo by the other two routes. A placebo group received three placebos and no glyco pyrrolate. Measurements and Main Results: Mouth conditions and intubat ing conditions were qualitatively assessed by the patient and the intu bating anesthesiologist. No difference between groups was noted. Oral and gastric volumes were measured and showed significantly less gastri c volume for the IV group as compared with the other groups. Oral secr etions were reduced in both the IV and IM groups when compared with pl acebo or glycopyrrolate administered orally. Conclusions: Preoperative glycopyrrolate is significantly more effective at reducing oral and g astric secretions if administered intravenously immediately before ind uction.