Abstract
Unexplained chest pain nowadays has become the leading reason for patients being referred for esophageal manometry. Some drugs are recently used as provocative agents to increase the diagnostic rate during this test and edrophonium chloride is the most common among them. Nevertheless, this provocative test has seldom been applied in Chinese patients. Therefore, we studied 158 consecutive patients with chest pain (group A) and 53 patients with other esophageal symptoms (group B) by using edrophonium as a provocative agent for inducing esophageal chest pain. Each of these patients received 80 μg/kg intravenous bolus dose of edrophonium preceded by saline infusions. Esophageal contractile pressures and contractile duration of upper middle and lower portions were measured before and after drug injection in response to ten 5 mL wet swallows. We found that chest pain was reproduced in only 8 patients and they were all in the group A. Besides, edrophonium increased esophageal pressure signficantly in all three monitored portions of esophageal body but increased contractile duration only in the middle and distal portions. We also found the adverse effects of this agent in such dose were mild and tolerable. In conclusion, edrophonium is relativly safe as a provocative agent and can diagnose chest pain of esophageal origin in small population of Chinese patients.
Published Version
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