Effect of Trospium Chloride on Duodenal Motility during Upper Gastrointestinal Endoscopy

Abstract

In a placebo-controlled, double-blind study the effects of depressing duodenal motility by administration of intravenous trospium chloride during gastroduodenoscopy were studied in 72 patients randomised to receive trospium chloride or saline (controls). Intravenous trospium chloride 1.2mg stopped the visible contractile activity of the duodenum as assessed by 3 independent observers during videoendoscopy within 76 seconds (median). During a 4-minute observation period of duodenal peristalsis, duodenal motor activity was found to stop in 18 of 36 patients after trospium chloride but in only 5 of 36 patients in the placebo group (p = 0.002). Adverse effects were dry mouth, micturition difficulties, sweat retention, accommodation disturbance and tachycardia. Trospium chloride was effective in reducing contractile activity in the duodenum. Its potent action and minor adverse effect profile appear to be promising for gastroduodenoscopy and especially for sphincter of Oddi motility in patients during routine endoscopic retrograde cholangiopancreatography.