Atropine Might Be Better Than Glycopyrrolate as an Adjunct to Ketamine in Children

But is either anticholinergic agent needed?

Some practitioners routinely administer an anticholinergic agent when giving ketamine to children because of theoretical concern that ketamine increases the volume of oral secretions. These authors performed a secondary review of 8282 instances of ketamine sedation pooled from 32 prior case series to determine the incidence of six adverse events (airway and respiratory adverse events, laryngospasm, apnea, emesis, recovery agitation, and clinically important recovery agitation) in children who received adjunctive atropine (47%), glycopyrrolate (22%), or no anticholinergic agent (31%).

Atropine was associated with significantly less vomiting than glycopyrrolate or no anticholinergic agent (5.3% vs. 10.7% and 11.4%). Glycopyrrolate was associat…

Reviewing Author

Diane M. Birnbaumer, MD, FACEP

Disclosures

Consultant / Advisory boardSecurisyn

Editorial boardsThe Merck Manuals (Home and Physician Editions)

Diane M. Birnbaumer, MD, FACEP

Disclosures

Consultant / Advisory boardSecurisyn

Editorial boardsThe Merck Manuals (Home and Physician Editions)