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Edrophonium Used for Vagotonic Action

George Kleinfeld, MD
JAMA. 1973;223(8):922-923. doi:10.1001/jama.1973.03220080052022.
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To the Editor.—  In a small, personal series of postoperative patients, certain observations have been made that suggest an additional therapeutic use for edrophonium chloride (Tensilon). Edrophonium belongs to a family of anticholinesterase agents, producing effects equivalent to continuous stimulation of cholinergic nerves, ie, continuous vagotonia.It is noted for rapid onset and brief duration of action. The principal use has been as a provocative drug for the diagnosis of myasthenia gravis or for supraventricular tachyarrhythmias.1While observing the intravenous administration of 10 mg of edrophonium chloride for a tachyarrhythmia in a patient postoperatively with protracted severe adynamic ileus, I was struck by the prompt onset of borborygmi and strong peristaltic sounds. Flatus and stool were produced. The bowel had been nearly silent for several days prior to the injection.The drug has since been used in 12 cases of postoperative ileus in doses ranging from 2.5 mg to

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