Effects of Hyosine N-butyl bromide on the detection of polyps during colonoscopy.
OBJECTIVE
Colonoscopy has a significant miss rate for colorectal polyp screening. The present study hypothesized that reduced colonic spasm with antispasmodic agents might yield a better visual field to result in enhanced polyp detection rate.


METHODS
In a prospective, randomized, double-blind study design, muscle spasm was recorded during insertion and withdrawal during routine colonoscopy, and the number of polyps detected were compared between two groups of 58 patients characterized with either hyosine N-butyl bromide (Hyosine group) or placebo (Placebo group) injected at reaching the cecum.


RESULTS
The number of patients with decrease in spasm score of 0, 1, and 2 between insertion and withdrawal were 5 (8.6%), 31 (53.4%), and 22 (37.9%) in the Hyosine group, and 10 (17.2%), 46 (79.3%), and 2 (3.4%) in the Placebo group, respectively (p < 0.001). In patients with spasm score > or = 3 during insertion, more polyps per patient were likely to be detected in the Hyoscine group than the Placebo group (1.21 +/- 2.23 vs. 0.41 +/- 0.91; p = 0.060).


CONCLUSIONS
Our study suggests that hyosine might increase the detection rate of polyps in patients with moderate to marked degree of colonic spasm during colonoscope insertion. Further large scale studies are needed to validate our observations.
Lee
Jung Min
JM
Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
Cheon
Jae Hee
JH
Park
Jae Jun
JJ
Moon
Chang Mo
CM
Kim
Eun Soo
ES
Kim
Tae Il
TI
Kim
Won Ho
WH
D000368:Aged; D002086:Butylscopolammonium Bromide / Q000008:administration & dosage; D003111:Colonic Polyps / Q000473:pathology* / Q000601:surgery*; D003113:Colonoscopy / Q000009:adverse effects / Q000379:methods*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010276:Parasympatholytics / Q000008:administration & dosage; D011446:Prospective Studies; D013035:Spasm / Q000209:etiology / Q000517:prevention & control*
D010276:Parasympatholytics; D002086:Butylscopolammonium Bromide