93526
document
Effects of atropine and scopolamine on bradycardia and emetic symptoms in otoplasty . OBJECTIVE To assess the effects of unilateral or bilateral otoplasty on bradycardia and postoperative nausea and vomiting ( PONV ) and the efficiency of transdermal scopolamine in the prophylaxis of PONV . STUDY DESIGN Post hoc assessment of the data from a double-blind , randomized study . METHODS Fifty otoplasty patients were studied ; half of them received randomly and in double-blind fashion a transdermal therapeutic system ( patch ) of scopolamine ( TTS-scopolamine ) as prophylaxis against PONV before general anesthesia . The placebo group received atropine 10 microg x kg ( -1 ) intravenously during induction . RESULTS The scopolamine-treated patients suffered more from moderate peroperative bradycardia ( 8/25 ; P < .05 ) than the atropine-treated patients ( 1/25 ) . Two patients wearing a half of the TTS-scopolamine patch needed intravenous atropine . After unilateral otoplasty , none of the TTS-scopolamine-treated patients and 50 % of the atropine-treated patients suffered from PONV . After bilateral operation , the respective incidences were 39 % and 81 % ( P < .01 ) . After unilateral otoplasty no patient needed droperidol , but after bilateral otoplasty , 12 of 19 of the atropine-treated and 4 of 18 ( P < .05 ) of the scopolamine-treated patients needed droperidol . The mean numbers of doses of droperidol were 0.8+/-0.9 and 0.3+/-0.6 ( P < .05 ) , respectively . Two additional patients , wearing half of the TTS-scopolamine patch , suffered from mild central anticholinergic syndrome . CONCLUSION TTS-scopolamine offers effective prophylaxis against PONV ( auriculoemetic reflex ) , but does not protect from bradycardia ( auriculocardiac reflex ) in otoplasty . Cutting of the TTS-scopolamine patch may lead to undesirable side effects .
93527
Intervention_Pharmacological
atropine
93528
Intervention_Pharmacological
scopolamine
93529
Intervention_Physical
unilateral or bilateral otoplasty
93530
Intervention_Pharmacological
scopolamine
93531
Intervention_Control
placebo
93532
Intervention_Control
atropine 10 microg x kg ( -1 ) intravenously
93533
Intervention_Pharmacological
scopolamine-treated
93534
Intervention_Pharmacological
atropine-treated
93535
Intervention_Pharmacological
TTS-scopolamine
93536
Intervention_Pharmacological
atropine
93537
Intervention_Pharmacological
TTS-scopolamine-treated
93538
Intervention_Pharmacological
atropine-treated
93539
Intervention_Pharmacological
scopolamine-treated
93540
Intervention_Pharmacological
droperidol
93541
Intervention_Pharmacological
TTS-scopolamine
93542
Intervention_Pharmacological
TTS-scopolamine
93543
Intervention_Pharmacological
TTS-scopolamine
93544
Outcome_Physical
bradycardia
93545
Outcome_Physical
emetic symptoms
93546
Outcome_Physical
bradycardia
93547
Outcome_Physical
postoperative nausea
93548
Outcome_Physical
vomiting ( PONV )
93549
Outcome_Physical
prophylaxis of PONV .
93550
Outcome_Physical
moderate peroperative bradycardia
93551
Outcome_Physical
intravenous atropine
93552
Outcome_Physical
PONV
93553
Outcome_Other
droperidol
93554
Outcome_Other
mean numbers of doses of droperidol
93555
Outcome_Adverse-effects
mild central anticholinergic syndrome
93556
Outcome_Other
prophylaxis
93557
Outcome_Physical
against PONV ( auriculoemetic reflex )
93558
Outcome_Physical
bradycardia ( auriculocardiac reflex )
93559
Outcome_Adverse-effects
side effects
93560
Participant_Condition
bradycardia
93561
Participant_Condition
emetic symptoms
93562
Participant_Sample-size
Fifty
93563
Participant_Condition
otoplasty