Effects of two anticholinergic drugs, trospium chloride and biperiden, on motility and evoked potentials of the oesophagus.
BACKGROUND
Anticholinergic drugs are known to impair the motor function of the oesophagus but their effects on the oesophageal afferent pathways are unknown.


OBJECTIVE
To determine the effects of a peripherally-acting (trospium chloride) and a centrally-acting (biperiden) anticholinergic drug on the motility and the evoked potentials of the oesophagus.


METHODS
Nine healthy volunteers were randomized to receive 1.2 mg trospium chloride (TC), 5 mg biperiden (BIP) or saline i.v. Primary peristalsis was elicited by swallowing a 5 mL water bolus and secondary peristalsis by insufflation of 20 mL air, 10 times each. Oesophageal potentials were evoked by electrical stimulation in the distal and proximal oesophagus (30 stimulations at 0.4 Hz, two runs).


RESULTS
Both anticholinergic drugs reduced by a similiar amount the contraction amplitudes (TC 17 mmHg, BIP 25 mmHg, saline 67 mmHg; P < 0.01) and the rate of secondary contractions (TC 60%, BIP 70%, saline 95%; P < 0.01). In contrast, only biperiden prolonged the latencies of the evoked potentials (N1 peak, distal oesophagus: BIP 191 ms, TC 102 ms, saline 101 ms; P < 0.01; P1 peak: BIP 322 ms, TC 161 ms, saline 144 ms; P < 0.01).


CONCLUSIONS
Both anticholinergic drugs depress oesophageal motility, but only the centrally-acting anticholinergic drug biperiden modifies the oesophageal evoked potentials, suggesting a central cholinergic transmission of the oesophageal afferent pathways.
Pehl
C
C
Department of Gastroenterology and Hepatology, Hospital Bogenhausen, Munich, Germany. 101604.3535@compuserve.com
Wendl
B
B
Kaess
H
H
Pfeiffer
A
A
D000328:Adult; D001561:Benzilates; D001712:Biperiden / Q000494:pharmacology; D018680:Cholinergic Antagonists / Q000494:pharmacology*; D004311:Double-Blind Method; D004947:Esophagus / Q000187:drug effects*; D005071:Evoked Potentials / Q000187:drug effects*; D005260:Female; D006801:Humans; D008297:Male; D009119:Muscle Contraction / Q000187:drug effects*; D009130:Muscle, Smooth / Q000187:drug effects; D009662:Nortropanes
D001561:Benzilates; D018680:Cholinergic Antagonists; D009662:Nortropanes; D001712:Biperiden; C003330:trospium chloride