Comparative Study of Current Dosing Practice of Atropine in Organophosphorus Poisoning at BLDE University Shri B M Patil Medical College and Hospital With Protocol Administration Practised at South Asian Clinical Toxicology Research Collaboration

ABSTRACT

Background: 1.Effect of atropinization with different methods.2.Outcomes in terms of duration of hospital stay and patients recovery. Methodology: An open-label randomized clinical trial was conducted in, Shri B M Patil Medical College Hospital and Reasearchcentre, Vijyapura, Karnataka in 108 individuals with OPC poisoning .We compared two groups that used a titrated dosing protocol based on a structured monitoring sheet for atropineinfusion with another group using an ‘ad hoc’ regime. The aim was to compare the efficacy andsafety of conventional bolus doses with individualized incremental doses of atropine for atropinization followed by continuous atropine infusion for management of OPC poisoning. Results: Out of 108 patients ,54 patients received conventional bolus dose atropine (group A) and 54 patient received rapidly incremental doses of atropine followed by infusion (group B).36 subjects analysed in group A and 32 in group B for moderate to severe poisoning.The mortality in group A was 11.1%(4/36) and in group B was 6.3%(2/32).The mean duration of atropinization in group A was 5.8hrs (348)in minutes compared to time 26.9minutes for group B. Conclusion: Administration of atropine using a fixed algorithm is easy and effective in providing the atropine requirement in management of early phase of acute OPC poisoning.Rapid incremental dose atropinization followed by atropine infusion reduces mortality and morbidity from OPC poisoning and shortens the length of hospital stay and early recovery .Incremental atropine and infusion should become the treatment of choice for OPC poisoning.