COMPARATIVE EFFICACY AND SAFETY OF NEBULIZED VERSUS INTRAMUSCULAR GLYCOPYRROLATE FOR FLEXIBLE BRONCHOSCOPY PREPARATION: A RANDOMIZED CONTROLLED TRIAL

Abstract

Background: Flexible bronchoscopy is widely used for pulmonary diagnostics, but preprocedural preparation is critical to manage secretions and enhance procedural success. Glycopyrrolate, administered either via nebulization or intramuscular injection, is effective for secretion control, though their comparative efficacy remains underexplored.

Aim and Objectives: This study aimed to compare the efficacy and safety of nebulized and intramuscular glycopyrrolate as preprocedural medications for flexible bronchoscopy, focusing on secretion management, procedural comfort, and safety profiles.

Materials and Methods: A randomized, double-blind controlled trial was conducted with 101 patients. Participants were assigned to receive either nebulized or intramuscular glycopyrrolate. Primary outcomes included secretion management and procedural comfort. Secondary outcomes evaluated adverse effects and patient satisfaction. Data were analyzed using GraphPad Prism version 9, with p < 0.05 considered statistically significant.

Results: Nebulized glycopyrrolate demonstrated superior secretion clearance (91.74 ± 18.23 mL vs. 86.64 ± 16.93 mL, p < 0.01) and reduced saline discrepancies (42.01 ± 9.11 mL vs. 46.26 ± 8.87 mL, p < 0.01). Both groups showed comparable patient satisfaction, with no significant difference in procedural comfort.

Conclusion: Nebulized glycopyrrolate offers superior secretion management and enhanced safety while maintaining comparable procedural comfort to intramuscular administration. These findings support its routine use in bronchoscopy preparation.