title: The role of routinely given hyoscine-N-butylbromide in colonoscopy: a double-blind, randomized, placebo-controlled, clinical trial.
abstract: OBJECTIVE
  Hyoscine-N-butylbromide (HBB) has been proposed to ease colonoscopy and improve mucosal visualization, yet the results from previous studies are conflicting. In our prospective, double-blind, placebo-controlled, randomized study we aimed at evaluating whether routine administration of HBB, before and during colonoscopy, ease the procedure or increase the detection rate for polyps.
  
  
  METHODS
  One hundred fifty outpatients scheduled for an elective colonoscopy were randomized to receive intravenous injections of either 10 mg hyoscine-N-butylbromide or saline before insertion and at cecum. Patient tolerance and technical ease of colonoscopy were evaluated by visual analogue scale (VAS). Procedure times were recorded. Number of detected polyps per patient was evaluated as well. Heart rate was monitored with a pulse oximetry.
  
  
  RESULTS
  HBB did not improve patient tolerance or technically ease the procedure as evaluated by VAS. However, HBB led to faster ileal intubation (1.5 vs 2.0 min, p < 0.001) and shorter total procedure time (22.0 vs 24.0 min, p = 0.03). Patients who received HBB also needed less often external abdominal pressure (48.6 vs 66.7%, p = 0.03). HBB did not improve polyp detection rate (0.89 vs 0.91, p = 0.90). HBB induced a significant rise in heart rate (p < 0.001) and more often tachycardia (17.6 vs 0%, p < 0.001).
  
  
  CONCLUSIONS
  Routine administration of HBB before and during colonoscopy yields only limited improvement in the technical performance of the examination compromised by high incidence of tachycardia.
authors.affiliation: a Department of Social Services and Health Care , Laakso Hospital , Helsinki , Finland.
authors.forename: Matti
authors.initials: M
authors.lastname: Ristikankare
authors.affiliation: a Department of Social Services and Health Care , Laakso Hospital , Helsinki , Finland.
authors.forename: Hannele
authors.initials: H
authors.lastname: Karinen-Mantila
mesh_terms: D000368:Aged; D001291:Attitude of Health Personnel; D002086:Butylscopolammonium Bromide / Q000008:administration & dosage* / Q000009:adverse effects; D003111:Colonic Polyps / Q000175:diagnosis*; D003113:Colonoscopy / Q000009:adverse effects / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000008:administration & dosage* / Q000009:adverse effects; D061646:Operative Time; D010146:Pain / Q000209:etiology; D017060:Patient Satisfaction; D011446:Prospective Studies; D013610:Tachycardia / Q000139:chemically induced
chemical_list: D018727:Muscarinic Antagonists; D002086:Butylscopolammonium Bromide
keywords: Colonoscopy; pain; polyps; scopolamine hydrobromide