Dr Rajani Thabah, Dr Nari M Lyngdoh, Dr Sunny Aggarwal, Dr Lanalyn Thangkhiew


In the past, anticholinergic agents were an inevitable premedicant in children as it reduces the oral secretions and bradycardia produced by
anaesthetic agents. However, controlled studies evaluating their effects produced mixed results and gradually their use over the years has been
declining. Presently, some of us still believe that anticholinergic agents are useful in children and continue to use glycopyrrolate as a premedication
in almost all paediatric patients. Even with the controversies over the use of glycopyrrolate as a premedication, we have never looked seriously at
the side effects of the anticholinergic drugs. The dry mouth caused by glycopyrrolate can be very uncomfortable for the patient, friable mucous
membrane and inspissated secretions can be life threatening. We report a case of a four year old child undergoing choledochal cyst excision and
hepaticojejunostomy with severe adverse respiratory event due to impacted inspissated secretions following glycopyrrolate premedication.


Glycopyrrolate, Anticholinergic agents, Premedication in Paediatric Anaesthesia, Perioperative adverse respiratory event.

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