Trial reportFrontiers in pharmacology2026
Effects of premedication with atropine, penehyclidine, and glycopyrrolate on postoperative delirium in older patients undergoing endoscopic gastric or esophageal submucosal dissection: a randomized, double-blind, multicenter, controlled clinical trial.
Trial report in Frontiers in pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
9 authors.
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Abstract
Background: Anticholinergic drugs are commonly used as premedication in clinical practice. The effects of premedication of atropine, penehyclidine, and glycopyrrolate on postoperative delirium in older patients remain unclear. Objective: The aim of this study was to observe the effects of premedication with atropine, penehyclidine, and glycopyrrolate on postoperative delirium (POD) in older patients undergoing endoscopic gastric or esophageal submucosal dissection. Methods: Older patients undergoing endoscopic gastric or esophageal submucosal dissection were randomly divided into atropine group (A group), glycopyrrolate group (G group), penehyclidine group (P group), and normal saline group (NS group), with 144 cases in each group. The primary outcome was the incidence of POD 24 h after surgery. The secondary outcomes were the incidence of POD 48 h and 72 h after surgery, perioperative saliva secretion levels, RASS scores, QoR-15 scores, VAS scores of dry mouth, postoperative nausea VAS scores, and severity of postoperative vomiting. Results: The incidence of POD 24 h after surgery was significantly higher in the A (20.1%) and P (23.6%) groups than in the NS group (9%) (95% CI, 0.030-0.191, Conclusion: Glycopyrrolate is more suitable as a premedication for older patients without aggravating postoperative delirium or prolonging dry mouth. Clinical Trial Registration: http://www.chictr.org.cn/showproj.html?proj=212300; Registration number: ChiCTR2300078413.
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