title: [Split-dose sodium picosulphate/magnesium citrate for morning colonoscopies performed 2 to 6 hours after fluid intake].
abstract: BACKGROUND
  Split dosage of bowel preparations has been shown to substantially improve bowel cleansing.
  
  
  OBJECTIVE
  To compare the split dose (SD) sodium picosulphate/magnesium oxide/anhydrous citric acid (Citrafleet(®)) regimen for morning colonoscopies with standard cleansing the day before.
  
  
  METHODS
  Consecutive outpatients were randomized to receive Citrafleet(®) the day before colonoscopy or SD, in whom the second half was administered on an individual basis from 2 to 6 hours before the procedure. No bisacodyl was administered. All procedures were performed with non-anesthesiologist administered propofol sedation. The Boston scale was used to assess the quality of bowel preparation (adequate cleansing if score ≥ 6, with no score of 0/1 in any segment).
  
  
  RESULTS
  A total of 193 patients were included. Overall bowel cleansing was significantly better in the SD group (7 vs. 5.2, p<0.001), as well as in the cecum (2.4 vs. 1.4, p < 0.001), ascending colon (2.5 vs. 1.6, p<0.001) and transverse colon (2.4 vs. 2, p=0.004). A significant proportion of SD patients had adequate bowel cleansing (71% vs. 30%, p<0.001). Patients in the SD group drank a greater amount of liquid (4.9 vs. 4 liters, p=0.006) and more frequently perceived the cleansing process to be easy or very easy to complete (89 vs. 68%, p=0.04), although they slept significantly fewer hours (6.5 vs. 7.9, p<0.001). No bronchoaspiration pneumonia was reported.
  
  
  CONCLUSIONS
  SD Citrafleet(®) 2 to 6 hours before colonoscopy increased the rate of procedures with adequate bowel cleansing by 40%, especially in the proximal colon, allowed more liquids to be drunk and increased the perception of ease in completing the preparation, with no sedation-related complications.
authors.affiliation: Servicio de Aparato Digestivo, Hospital San Pedro de Alcántara, Cáceres, España.
authors.forename: Elisa
authors.initials: E
authors.lastname: Martín-Noguerol
authors.forename: Jesus M
authors.initials: JM
authors.lastname: González-Santiago
authors.forename: Carmen
authors.initials: C
authors.lastname: Martínez-Alcalá
authors.forename: Gema
authors.initials: G
authors.lastname: Vinagre-Rodríguez
authors.forename: Moisés
authors.initials: M
authors.lastname: Hernández-Alonso
authors.forename: Carmen
authors.initials: C
authors.lastname: Dueñas-Sadornil
authors.forename: Belén
authors.initials: B
authors.lastname: Pérez-Gallardo
authors.forename: José M
authors.initials: JM
authors.lastname: Mateos-Rodríguez
authors.forename: Miguel
authors.initials: M
authors.lastname: Fernández-Bermejo
authors.forename: Javier
authors.initials: J
authors.lastname: Molina-Infante
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002400:Cathartics / Q000008:administration & dosage* / Q000009:adverse effects; D002951:Citrates / Q000008:administration & dosage* / Q000009:adverse effects; D019343:Citric Acid / Q000008:administration & dosage* / Q000009:adverse effects; D003113:Colonoscopy; D003967:Diarrhea / Q000139:chemically induced; D004327:Drinking Behavior; D004334:Drug Administration Schedule; D005239:Fear; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds / Q000008:administration & dosage* / Q000009:adverse effects; D010342:Patient Acceptance of Health Care; D010847:Picolines / Q000008:administration & dosage* / Q000009:adverse effects; D012892:Sleep Deprivation; D055815:Young Adult
chemical_list: D002400:Cathartics; D002951:Citrates; D009942:Organometallic Compounds; D010847:Picolines; D019343:Citric Acid; C005701:picosulfate sodium; C110422:magnesium citrate