At one time, atropine or scopolamine was routinely administered before the induction of general anesthesia to block excessive salivary and respiratory secretions induced by certain inhalation anesthetics (e.g., diethyl ether). With the newer, less irritating anesthetics, an-timuscarinic premedication is not routinely required as an antisialagogue (i.e., to counteract the formation of saliva). Sedation can occur following scopolamine administration, and preanesthetic or postoperative agitation has been observed in some patients. High serum levels of drugs with antimuscarinic activity can produce postoperative delirium. Glycopyrrolate bromide (Robinul) has also been given intramuscularly as a preanesthetic medication with satisfactory results. This agent is a quaternary ammonium compound and therefore produces no central effects.
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