Do small doses of atropine (<0.1 mg) cause bradycardia in young children?

Archives of Disease in Childhood
Lara EisaChristopher Heard

Abstract

To determine the heart rate response to atropine (<0.1 mg) in anaesthetised young infants. Prospective, observational and controlled. Elective surgery. Sixty unpremedicated healthy infants less than 15 kg were enrolled. Standard monitoring was applied. Anaesthesia was induced by mask with nitrous oxide (66%) and oxygen (33%) followed by sevoflurane (8%). Intravenous (IV) atropine (5 µg/kg) was flushed into a fast flowing IV. The ECG was recorded continuously from 30 s before the atropine until 5 min afterwards. The incidence of bradycardia and arrhythmias was determined from the ECGs by a blinded observer. The median (IQR) age was 6.5 (4-12) months and the mean (95% CI) weight was 8.6 (8.1 to 9.1) kg. The mean (95% CI) dose of atropine was 40.9 (37.3 to 44) µg. Bradycardia did not occur. Two infants developed premature atrial contractions and one developed a premature ventricular contraction. When compared with baseline values, heart rate increased by 7% 30 s after atropine, 14% 1 min after atropine and 25% 5 min after atropine. Twenty-nine infants (48%) experienced tachycardia (>20% above baseline rate) after atropine lasting 222.7 s (range 27.9-286). The change in heart rate 5 min after atropine was inversely related to the b...Continue Reading

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References

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Citations

Jan 20, 2016·Seminars in Cardiothoracic and Vascular Anesthesia·Mark Twite, Richard J Ing
Jul 26, 2017·Singapore Medical Journal·Gene Yong Kwang OngUNKNOWN National Resuscitation Council Singapore
Mar 29, 2021·Resuscitation·Patrick Van de VoordeIan Maconochie
Jun 8, 2021·Notfall & Rettungsmedizin·Patrick Van de VoordeIan Maconochie

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