Comparison Of Salbutamol Alone And Salbutamol In Combination With Ipratropium Bromide In The Treatment Of Acute Asthma In Children.

Abstract

Background: Acute attacks of childhood bronchial asthma can be life-threatening if not timely and appropriately managed. This study aimed to compare the mean pulmonary asthma score in salbutamol alone versus salbutamol combined with ipratropium bromide for managing childhood acute asthma. Methods: This single-blind, parallel-group, randomized controlled trial was performed at the Pediatric Medicine department, The Children’s Hospital & the Institute of Child Health, Multan, from January 1, 2024, to June 30, 2024. A total of sixty children of 2–15 years with an acute asthma episode were consecutively enrolled after parental consent. Exclusions included congenital pulmonary/cardiac malformations, bronchopulmonary dysplasia, cystic fibrosis, bronchiolitis obliterans, and imminent respiratory failure. Patients were randomly divided into group A and group B treatment groups. Group A received nebulization of 0.5% salbutamol alone, while Group B received salbutamol with ipratropium bromide. Pulmonary Asthma Score (PAS) was assessed on presentation and after 4 hours. Descriptive statistics are run using SPSS. PAS after 4 hours of treatment between the groups was compared through a t-test, and a p-value <0.05 was taken as significant. Results: The mean age was 8.6 ± 2.8 years with equal gender distribution. Baseline PAS was comparable (10.2 ± 1.2 vs 10.6 ± 1.2, p = 0.295). After 4 hours, overall PAS declined to 7.4 ± 1.6, with significantly lower scores in the combination group (6.3 ± 1.2) versus salbutamol alone (8.4 ± 1.2, p < 0.001). Stratified analysis confirmed these results except among children on montelukast (p = 0.846). Conclusion: Nebulization with salbutamol plus ipratropium bromide significantly reduces PAS at 4 hours compared to salbutamol alone in acute pediatric asthma.

Keywords

• Asthma
• Salbutamol
• Pulmonary Asthma
• Ipratropium Bromide