Comparison of no medication, placebo, and hyoscyamine for reducing pain during a barium enema.
OBJECTIVE
We carried out a prospective, randomized study to evaluate the usefulness of premedication with an oral anticholinergic for relief of pain during and after a barium enema of the colon.


METHODS
Patients were randomized into three groups: no medication, placebo, and sublingual 1-hyoscyamine sulfate. The placebo or hyoscyamine tablet was placed under the tongue 15-30 min before the examination. After the procedure the patients were interviewed. An analog scale (0-10) was used to score the level of pain that the patients experienced during the examination. Forty-eight hours after the examination, the patients returned by mail a survey that used the same scale and asked about delayed pain.


RESULTS
Data from 110 patients were studied. Sixty-nine patients were women, and 41 were men. They ranged from 24 to 82 years old (mean, 55 years). For the no-medication group (n = 36), the mean pain score was 4.1; for the placebo group (n = 34), 3.8; and for the hyoscyamine group (n = 40), 4.2. No statistically significant difference in pain scores was found between any groups (p = .72). Six patients from each group reported minor side effects. The mean scores from the returned surveys (n = 79) were 3.8 for the no-medication group (n = 26) and placebo group (n = 22) and 3.1 for the hyoscyamine group (n = 31). No statistically significant difference was found between any of these groups (p = .48) or between delayed pain responses and initial pain responses (p = .27).


CONCLUSIONS
Although safe, hyoscyamine seems to provide no benefit over no drug or a placebo when used as a pain premedication for patients undergoing a barium enema.
Bova
J G
JG
Department of Radiology, The Ohio State University Medical Center, Columbus 43210, USA.
Bhattacharjee
N
N
Jurdi
R
R
Bennett
W F
WF
D001285:Atropine / Q000627:therapeutic use*; D001466:Barium Sulfate; D018680:Cholinergic Antagonists / Q000627:therapeutic use*; D003287:Contrast Media; D004733:Enema; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000517:prevention & control*; D010147:Pain Measurement; D011292:Premedication; D011446:Prospective Studies
D018680:Cholinergic Antagonists; D003287:Contrast Media; D001466:Barium Sulfate; D001285:Atropine