title: The effect of timing of intravenous muscle relaxant on the quality of double-contrast barium enema.
abstract: OBJECTIVE
  To determine whether the timing of buscopan administration during double-contrast barium enema examination (DCBE) affects diagnostic quality.
  
  
  METHODS
  In a prospective setting, 100 consecutive adult out-patients referred for DCBE received 20 mg buscopan (hyoscine-N-butylbromide) intravenously, either before infusion of barium suspension (Group A) or after barium infusion and gas insufflation (Group B). A subjective assessment of ease of contrast medium infusion was made at the time of examination and the films subsequently analysed by two radiologists unaware of the mode of relaxant administration, who noted the quality of mucosal coating and made subjective and objective measurements of segmental distension.
  
  
  RESULTS
  There was no significant difference in screening times, infusion difficulty or colonic contrast medium coating between the two groups. Subjective assessment of distension of the caecum, ascending colon, transverse colon and rectum were not significantly different. Patients receiving intravenous relaxant after barium and gas infusion had less subjective descending (P = 0. 05) and sigmoid (P = 0.04) colon distension, but there was no significant difference with respect to maximal bowel diameter in any of the segments measured.
  
  
  CONCLUSIONS
  The timing of intravenous administration during DCBE is likely to have no significant effect on the diagnostic quality of the study.
authors.affiliation: Department of Radiology, Northwick Park Hospital, Harrow, Middlesex, UK.
authors.forename: E M
authors.initials: EM
authors.lastname: Elson
authors.forename: D M
authors.initials: DM
authors.lastname: Campbell
authors.forename: S
authors.initials: S
authors.lastname: Halligan
authors.forename: I
authors.initials: I
authors.lastname: Shaikh
authors.forename: S
authors.initials: S
authors.lastname: Davitt
authors.forename: C I
authors.initials: CI
authors.lastname: Bartram
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001466:Barium Sulfate; D002086:Butylscopolammonium Bromide / Q000008:administration & dosage*; D003106:Colon / Q000000981:diagnostic imaging; D003287:Contrast Media; D004334:Drug Administration Schedule; D004733:Enema; D006801:Humans; D007275:Injections, Intravenous; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000008:administration & dosage*; D011446:Prospective Studies; D011859:Radiography
chemical_list: D003287:Contrast Media; D018727:Muscarinic Antagonists; D001466:Barium Sulfate; D002086:Butylscopolammonium Bromide