Role of Atropine in Attenuating the Side Effects of Propofol in Procedural Sedation in Anterior Shoulder Dislocation Reduction: A Randomized Controlled Trial

Abstract

Background: Propofol administration is associated with apnea, bradycardia, hypotension, and injection-site pain.Aim of the work: To determine the impact of atropine in reducing the adverse effects of propofol used in procedural sedation for anterior shoulder dislocation [ASD] reduction.Patients and Methods: This randomized, controlled, single-blind study was carried out on 50 patients aged from 18 to 60 years old, both sexes, undergoing ASD reduction. Patients were randomly assigned to two equal groups. Patients received 0.6 mg atropine in group 1 and saline in group 2 before propofol administration. Propofol 2 mg/kg and fentanyl 1 mcg/kg were utilized for sedation. Monitoring of heart rate [HR], and mean arterial pressure [MAP] were started just before the administration of atropine [T0] and at a one-minute interval after induction for 15 minutes [T1 -T15]. The incidence of apnea was recorded after propofol administration.Results: The incidence of apnea was significantly lower with atropine compared to the control group [8% vs. 44%, P=0.004]. HR was significantly higher from T1 to T15 in group 1 compared to group 2 [P <0.05]. MAP was significantly higher from T5 to T15 group 1 than in group 2 [P <0.05]. Hypotension [MAP<65mmHg] and bradycardia [HR<60 beats/min] were insignificantly different between both groups. Allergies did not occur in both groups.Conclusion: In ASD reduction, atropine attenuates the negative effects of propofol by reducing the incidence of apnea and avoiding the decrease in HR and MAP.