Comparison of the incidence of complications at induction and emergence ininfants receiving oral atropine vs no premedication

We studied 120 patients less than I yr of age, allocated randomly to receiv e atropine 40 mu g kg(-1) orally 1 h before operation (group A) or no preme dication (group B). All patients underwent a standardized anaesthetic, incl uding inhalation induction with halothane followed by atracurium 0.5 mg kg( -1), tracheal intubation and positive pressure ventilation. Monitoring duri ng anaesthesia included heart rate, arterial oxygen saturation, temperature and airway conditions at induction and emergence. The incidence of a decre ase in arterial oxygen saturation to 94% or less at induction and recovery was similar in both groups (30.5% at induction, 39% at extubation in group A; 31% at induction, 41% at extubation in group B). There were significantl y more airway complications in group B both at induction and emergence (25% and 49%, respectively, compared with 9% and 25% in group A; P < 0.015). Me an heart rate at induction and in the peroperative period was significantly higher in the group receiving atropine (P less than or equal to 0.001). Th ere was an increased incidence of bradycardia (decrease in heart rate of gr eater than or equal to 20%) at induction in the non-premedicated group (23% in group B compared with 10% in group A), but this was not statistically s ignificant. We conclude that the incidence of airway complications at induc tion and emergence was reduced by orally administered atropine premedicatio n.