Colon distension, perceived burden and side-effects of CT-colonography for screening using hyoscine butylbromide or glucagon hydrochloride as bowel relaxant.
OBJECTIVE
Compare colonic distension and perceived burden of CT-colonography between participants receiving hyoscine butylbromide (buscopan) and glucagon hydrochloride as bowel relaxant.


METHODS
Data were collected within a screening trial. Participants received 20mg buscopan intravenously or 1mg of glucagon intravenously (if buscopan contra-indicated). Colon distension per segment was assessed using a 4-point scale (prone and supine). Data on perceived burden of CT-colonography were collected using a questionnaire two weeks after the examination. Outcome measures between groups were compared using propensity score matching. We used a stratified Wilcoxon-Mann-Whitney test statistic for quantitative and Cochran-Mantel-Haenszel statistics for categorical variables.


RESULTS
541 participants were included: 336 (62%) received buscopan and 205 received glucagon. All buscopan recipients had an adequately distended colon, compared to 96% in the glucagon group (RR 7.31, 95% CI: 1.61-33.28). More glucagon recipients scored the insufflation as rather or extremely burdensome (25% vs. 16%; overall mean score 2.7 vs. 2.4; p<0.001) and more found the entire CT-colonography rather or extremely burdensome (14% vs. 7%; 2.2 vs. 1.9; p=0.001). Most frequently reported side effects were a dry mouth in the buscopan group (15%) and nausea in the glucagon group (13%).


CONCLUSIONS
Compared to glucagon, premedication with buscopan results in significantly more adequately distended colons and a less burdensome procedure. When buscopan can be used, it is the preferred bowel relaxant.
Department of Radiology, Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. margrietcdehaan@gmail.com
Margriet C
MC
de Haan
Thierry N
TN
Boellaard
Patrick M
PM
Bossuyt
Jaap
J
Stoker
D000368:Aged; D002086:Butylscopolammonium Bromide; D018678:Cholinergic Agents; D003106:Colon / Q000000981:diagnostic imaging* / Q000187:drug effects; D023881:Colonography, Computed Tomographic / Q000379:methods* / Q000706:statistics & numerical data; D015897:Comorbidity; D003287:Contrast Media; D005260:Female; D005765:Gastrointestinal Agents; D006801:Humans; D007483:Iothalamic Acid / Q000031:analogs & derivatives*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010146:Pain / Q000453:epidemiology* / Q000517:prevention & control*; D017060:Patient Satisfaction; D015995:Prevalence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D018678:Cholinergic Agents; D003287:Contrast Media; D005765:Gastrointestinal Agents; D007483:Iothalamic Acid; D002086:Butylscopolammonium Bromide; C002587:ioxitalamic acid