Factors that affect the variability in heart rate during endoscopic retrograde cholangiopancreatography.
OBJECTIVE
To find out if drugs, position, and endoscopic manipulation during endoscopic retrograde cholangiopancreatography (ERCP) influence the changes in the variability of heart rate.


METHODS
Single-blind randomised trial.


METHODS
10 volunteers given butyscopolamine, glucagon, or saline intravenously on three different study days, and 10 patients who had ERCP without butylscopolamine or glucagon.


METHODS
Holter tape analysis for ischaemia and changes in the variability of heart rate.


RESULTS
5 volunteers developed tachycardia after butylscopolamine, while 2 developed tachycardia after glucagon. During ERCP 9 patients developed tachycardia, and 2 developed myocardial ischaemia. Vagal tone decreased in the volunteers after butylscopolamine, but no changes were seen after glucagon or placebo, or in patients during ERCP.


CONCLUSIONS
Butylscopolamine reduced vagal tone in volunteers. Patients who were having ERCP without butylscopolamine had a stable vagal tone. The previously observed reduced vagal tone during ERCP may therefore be primarily the result of giving butylscopolamine.
Christensen
Merete
M
Dept. of Surgical Gastroenterology, Hvidovre Hospital, Hvidovre, Denmark. merete.christensen@dadlnet.dk
Reinert
Rebekka
R
Rasmussen
Verner
V
Schulze
Svend
S
Rosenberg
Jacob
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001341:Autonomic Nervous System / Q000187:drug effects / Q000502:physiology; D002086:Butylscopolammonium Bromide / Q000494:pharmacology*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects* / Q000379:methods*; D015716:Electrocardiography, Ambulatory; D005260:Female; D005765:Gastrointestinal Agents / Q000494:pharmacology*; D005934:Glucagon / Q000494:pharmacology*; D006339:Heart Rate / Q000187:drug effects* / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000139:chemically induced / Q000175:diagnosis / Q000209:etiology; D010276:Parasympatholytics / Q000494:pharmacology*; D011187:Posture / Q000502:physiology; D016037:Single-Blind Method; D012965:Sodium Chloride / Q000494:pharmacology*; D013610:Tachycardia / Q000139:chemically induced / Q000175:diagnosis / Q000209:etiology
D005765:Gastrointestinal Agents; D010276:Parasympatholytics; D002086:Butylscopolammonium Bromide; D012965:Sodium Chloride; D005934:Glucagon