Quantitative appraisal of Picolax (sodium picosulfate/magnesium citrate) in the preparation of the large bowel for elective surgery.
The authors have investigated the metabolic sequelae Picolax bowel preparation in a group receiving their preparation either 24 hours (n = 17) or 48 hours (n = 18) before elective colonic resection. No significant changes in any metabolic parameter were found in the 24-hour group. In the 48-hour group, there was a significant decrease in serum sodium (P less than 0.005), serum chloride (P less than 0.005), pH (P less than 0.005), HCO3 (P less than 0.005), and base excess (P less than 0.005). Only 16 of 35 cases (46 percent) had an acceptable bowel preparation: 11 of 17 (65 percent) in the 24-hour group and 5 of 18 (28 percent) in the 48-hour group. Marker studies did not correlate with the quality of bowel preparation. The risk of potentially explosive intraluminal gas was increased if the bowel preparation was poor: 12 of 19 patients (63 percent) with a poor bowel preparation compared with 3 of 16 patients (19 percent) of those with an acceptable preparation (P less than 0.005). Picolax is a poor mechanical bowel preparation and is associated with unacceptable physiologic disturbance if given two days before surgery.
Takada
H
H
Department of Surgery, Queen Elizabeth Hospital, Edgbaston, Birmingham, England.
Ambrose
N S
NS
Galbraith
K
K
Alexander-Williams
J
J
Keighley
M R
MR
D000136:Acid-Base Equilibrium / Q000187:drug effects; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002400:Cathartics / Q000009:adverse effects / Q000494:pharmacology*; D002712:Chlorides / Q000097:blood; D002951:Citrates; D005260:Female; D006801:Humans; D007420:Intestine, Large / Q000502:physiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D010847:Picolines / Q000009:adverse effects / Q000494:pharmacology*; D011188:Potassium / Q000097:blood; D011300:Preoperative Care; D012964:Sodium / Q000097:blood; D013997:Time Factors; D014882:Water-Electrolyte Balance / Q000187:drug effects*
D002400:Cathartics; D002712:Chlorides; D002951:Citrates; D009942:Organometallic Compounds; D010847:Picolines; D012964:Sodium; C005701:picosulfate sodium; D011188:Potassium