title: Colonic distention at CT colonography: randomized evaluation of both IV hyoscine butylbromide and automated carbon dioxide insufflation.
abstract: OBJECTIVE
  The purpose of this article is to evaluate the efficacy of IV hyoscine butylbromide as a bowel relaxant and automated carbon dioxide insufflation in CT colonography in terms of colonic distention and perceived burden. SUBJECTS AND METHODS; Two hundred twenty-four participants were randomly allocated to one of four groups: control (no bowel relaxant and IV saline placebo before CT colonography with manual carbon dioxide insufflation), hyoscine butylbromide (IV hyoscine butylbromide before examination with manual carbon dioxide insufflation), automated (no bowel relaxant before examination with automated carbon dioxide insufflation), and combined (hyoscine butylbromide before examination with automated carbon dioxide insufflation). The degree of colonic distention on a 4-point scale, examination time, and participants' satisfaction, as measured by their responses to a questionnaire, were assessed.
  
  
  RESULTS
  The mean distention grades of all the colonic segments and both positions were 3.22 in the control group, 3.28 in the hyoscine butylbromide group, 3.77 in the automated group, and 3.74 in the combined group. Compared with manual carbon dioxide insufflation, automated carbon dioxide insufflation significantly improved the clinical adequacy of colonic distention and shortened examination time. No statistically significant difference was seen in the clinical adequacy of distention between participants who received hyoscine butylbromide and those who did not, or in examination time. Overall, the participants' experiences were not different.
  
  
  CONCLUSIONS
  Colonic distention was statistically significantly improved by automated carbon dioxide insufflation, but not by the administration of hyoscine butylbromide. The participants' tolerance was similar in each group.
authors.affiliation: 1 Department of Radiology, Kameda Medical Center Makuhari, Chiba, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Nagata
authors.forename: Masanori
authors.initials: M
authors.lastname: Fujiwara
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shimamoto
authors.forename: Nao
authors.initials: N
authors.lastname: Iida
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Mogi
authors.forename: Toru
authors.initials: T
authors.lastname: Mitsushima
mesh_terms: D000368:Aged; D002086:Butylscopolammonium Bromide / Q000008:administration & dosage; D002245:Carbon Dioxide / Q000008:administration & dosage; D003106:Colon / Q000000981:diagnostic imaging* / Q000187:drug effects*; D023881:Colonography, Computed Tomographic / Q000379:methods*; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging*; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007327:Insufflation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D002245:Carbon Dioxide; D002086:Butylscopolammonium Bromide
keywords: CT colonography; automated insufflation; butylscopolammonium bromide; distention; hyoscine butylbromide