Preoperative glycopyrrolate: Oral, intramuscular, or intravenous administration

Study Objective: To evaluate the effects of oral, intramuscular (IM) and intravenous (IV) glycopyrrolate on oral and gastric secretions, and to assess how these routes of administration change intubating conditions. Design: Randomized, double-blinded study. Setting: University hospital operating room Patients: 37 ASA status I and II general anesthesia patients Interventions: Patients were randomized to receive glycopyrrolate or placebo just before surgery by three routes: oral, IM, and IV. Glycopyrrolate was received once by one route and placebo by the other two routes. A placebo group received three placebos and no glycopyrrolate. Measurements and Main Results: Mouth conditions and intubating conditions were qualitatively assessed by the patient and the intubating anesthesiologist. No difference between groups was noted. Oral and gastric volumes were measured and showed significantly less gastric volume for the IV group as compared with the other groups. Oral secretions were reduced in both the IV and IM groups when compared with placebo or glycopyrrolate administered orally. Conclusions: Preoperative glycopyrrolate is significantly more effective at reducing oral and gastric secretions if administered intravenously immediately before induction.