Hyoscine N-butyl Bromide Research Articles

PWE-042 Colonoscopy Quality Measures: Experience from a Welsh Bowel Cancer Screening Centre

IntroductionThe NHS Bowel Cancer Screening Programme (BCSP) in England has demonstrated high quality colonoscopy [1]. Bowel Cancer Screening in Wales began in October 2008. We report results of first 3...

Simultaneous Determination of Hyoscine N- Butyl Bromide and Paracetamol by RP-TLC Spectrodensitometric Method

Aims: A simple RP-TLC Spectrodensitometric method was developed for determination of Hyoscine N-Butyl Bromide (HBB) and Paracetamol (PAR) either in bulk powder or in their pharmaceutical preparation. Study Design: Validation study. Methodology: In this method, HBB and PAR were separated on RP-18 W/ UV254 TLC plates using developing mobile phase consisting of methanol: citrate buffer (pH=1.5): triflouroacetic acid (70:30:0.1, by volume) at room temperature. Experimental conditions such as band size, slit width, different developing systems and scanning wavelength were carefully studied and the optimum conditions were selected. The obtained bands were then scanned at 210 nm. The two drugs were satisfactorily resolved with RF 0.60 ± 0.02 for HBB and 0.81 ± 0.02 for PAR. The validation of spectrodensitometric method was done regarding linearity, accuracy, precision, and specificity. Results: Linearity of the proposed methods was evaluated and it was found to lie within the concentration range of 2.0-12.0 µg.band-1 for HBB and 2.0-14.0 µg.band-1 for PAR. Conclusion: The proposed method was successfully applied for determination of HBB and PAR in pure form and in their different pharmaceutical formulations. The method proved to be specific, accurate and selective.

Mo1597 The Effect of Hyoscine N-Butyl-Bromide on Adenoma Detection Rate: a Meta-Analysis of Randomized Clinical Trials

The administration of anti-spasmodic drugs during colonoscopy may improve mucosal visualization by reducing colonic motility. As such, the impact of these agents on adenoma detection rate (ADR) has been evaluated. However, conflicting results have been reported on the impact of Hyoscine N-butyl-bromide (HBB) on ADR in individual trials.

Hyoscine N-butylbromide for adenoma detection during colonoscopy: A randomized, double-blind, placebo-controlled study

Hyoscine N-butylbromide (HBB), commonly used during colonoscopy to facilitate cecal intubation, has been proposed to increase the adenoma detection rate (ADR). To evaluate whether HBB administration increases the adenoma detection rate and influences patients' tolerance. Consecutive colonoscopy outpatients were randomized after cecal intubation to receive either 20mg HBB or placebo i.v. The number, size, histology and location of polyps were recorded. The air retained in the abdomen was either indirectly estimated by ΔAC (difference in the abdominal circumference measured before and after colonoscopy) or directly evaluated by patients' perception (visual analogic scale, range 0-100). 402 patients (44% male; mean age 57.7±12.5years) received either HBB or placebo. No differences in ADR (31.7% vs. 28%, p=0.48), advanced-ADR (7.4% vs. 10.5%, p=0.35) were observed between HBB and placebo group, respectively. A significantly lower detection rate of flat/depressed lesions was observed in the HBB group (0.5% vs. 5.5%, p=0.003). The ΔAC and the bloating perception were comparable between the two groups (p=0.22 and p=0.48, respectively). HBB administered before colonoscope withdrawal does not increase adenoma detection rate and seems to hamper the visualization of flat/depressed lesions. This finding raises concerns on the indiscriminate use of HBB during colonoscopy.

Simultaneous Determination of Hyoscine N- Butyl Bromide and Paracetamol by RP-TLC Spectrodensitometric Method

Aims: A simple RP-TLC Spectrodensitometric method was developed for determination of Hyoscine N-Butyl Bromide (HBB) and Paracetamol (PAR) either in bulk powder or in their pharmaceutical preparation. Study Design: Validation study. Methodology: In this method, HBB and PAR were separated on RP-18 W/ UV254 TLC plates using developing mobile phase consisting of methanol: citrate buffer (pH=1.5): triflouroacetic acid (70:30:0.1, by volume) at room temperature. Experimental conditions such as band size, slit width, different developing systems and scanning wavelength were carefully studied and the optimum conditions were selected. The obtained bands were then scanned at 210 nm. The two drugs were satisfactorily resolved with RF 0.60 ± 0.02 for HBB and 0.81 ± 0.02 for PAR. The validation of spectrodensitometric method was done regarding linearity, accuracy, precision, and specificity. Results: Linearity of the proposed methods was evaluated and it was found to lie within the concentration range of 2.0-12.0 µg.band-1 for HBB and 2.0-14.0 µg.band-1 for PAR. Conclusion: The proposed method was successfully applied for determination of HBB and PAR in pure form and in their different pharmaceutical formulations. The method proved to be specific, accurate and selective.

LC-MS as a Stability-Indicating Method for Analysis of Hyoscine N-Butyl Bromide under Stress Degradation Conditions with Identification of Degradation Products

Hyoscine N-Butyl Bromide (HBB) was subjected to different ICH prescribed stress conditions. It showed extensive decomposition under base hydrolytic conditions, while it was less liable to stress acid hydrolytic conditions. It showed also moderate degradation in response to oxidation stress of hydrogen peroxide. The drug showed no changes under photolysis conditions. In total, a number of major degradation products were detected by HPLC and identified by LC-MS. For establishment of stability-indicating assay, the reaction solutions in which different degradation products were formed were prepared, and the separation was optimized by varying the HPLC conditions. An acceptable chromatograms was achieved using a C18 column using (water: methanol 50: 50 v/v, pH adjusted to 3.9 with triflouroacetic acid) as a mobile phase with flow rate of 1.0 ml min−1 and UV detection wavelength at 210 nm. The percent of degradation was calculated in each run by measuring the intensity of the peak area of the intact drug at 6.2 min. Complete degradation only occur in case of 5 N NaOH indicates that the drug is very sensitive to alkaline hydrolysis. The LC-MS study was carried out to identify the major degradation products using a sunfire (waters) C-18 column and a mobile phase comprising of acetonitrile: 0.1M ammonium acetate (80:20, v/v) with flow rate of 1.0 ml min−1. MS measurements were acquired in positive ion full scan modes from 50 to 400 amu. The m/z values of the main peaks were investigated with the expected chemical structure of degradates.

Prostate magnetic resonance imaging at 3 Tesla: Is administration of hyoscine-N-butyl-bromide mandatory?

To evaluate the value of administration of hyoscine-N-butyl-bromide (HBB) for image quality magnetic resonance imaging (MRI) of the prostate. Seventy patients were retrospectively included in the study. Thirty-five patients were examined with administration of 40 milligrams of HBB (Buscopan(®); Boehringer, Ingelheim, Germany); 35 patients were examined without HBB. A multiparametric MRI protocol was performed on a 3.0 Tesla scanner without using an endorectal coil. The following criteria were evaluated independently by two experienced radiologists on a five-point Likert scale: anatomical details (delineation between peripheral and transitional zone of the prostate, visualisation of the capsule, depiction of the neurovascular bundles); visualisation of lymph nodes; motion related artefacts; and overall image quality. Comparison of anatomical details between the two cohorts showed no statistically significant difference (3.9 ± 0.7 vs 4.0 ± 0.9, P = 0.54, and 3.8 ± 0.7 vs 4.2 ± 0.6, P = 0.07) for both readers. There was no significant advantage regarding depiction of local and iliac lymph nodes (3.9 ± 0.6 vs 4.2 ± 0.6, P = 0.07, and 3.8 ± 0.9 vs 4.1 ± 0.8, P = 0.19). Motion artefacts were rated as "none" to "few" in both groups and showed no statistical difference (2.3 ± 1.0 vs 1.9 ± 0.9, P = 0.19, and 2.3 ± 1.1 vs 1.9 ± 0.7, P = 0.22). Overall image quality was rated "good" in average for both cohorts without significant difference (4.0 ± 0.6 vs 4.0 ± 0.9, P = 0.78, and 3.8 ± 0.8 vs 4.2 ± 0.6, P = 0.09). The results demonstrated no significant effect of HBB administration on image quality. The study suggests that use of HBB is not mandatory for MRI of the prostate at 3.0 Tesla.

Hyoscine-N-butyl-bromide-induced hypotension and myocardial ischemia.

Hyoscine N-butyl bromide, also known as scopolamine, is a type of antimuscarinic agent. This drug is associated with numerous common side effects, including abdominal fullness, constipation, urinary retention, blurred vision, skin flushing, tachycardia, decreased sweating, and salivation. The most unfavorable side effect is hemodynamic instability. In the present case, hypotension and acute myocardial infarction developed after intravenous hyoscine injection as a premedication therapy for colonoscopy. It was difficult to differentiate the cause-effect relationship between myocardial infarction and hypotension. Because both conditions were present under drug effects, we considered 2 possible diagnoses. One was coronary spasm with cardiogenic shock, and the other was myocardial ischemic sequela due to shock status. The latter diagnosis was confirmed after a series of examinations.

The Administration of Hyoscine N-butyl Bromide During Colonoscopy Does Not Increase the Adenoma Detection: A Randomized, Double-blind, Controlled Study

Purpose: The administration of anti-spasmotic drugs during colonoscopy has been proposed to increase the adenoma detection rate (ADR). However, conflicting results have been reported on the impact of Hyoscine N-butyl-bromide (HBB) on ADR. The primary outcome of the study was to test whether the administration of HBB, at time of cecal intubation, increases the polyp and adenoma detection. The HBB safety, the entity of abdominal distension at the end of the procedure and the patient's bloating perception were also evaluated. Methods: Consecutive colonoscopy adult outpatients were considered for the study. Exclusion criteria were represented by co-morbidities regarded as contraindications to HBB administration, previous intestinal resection and history of IBD. After cecal intubation, patients were randomized in a double blind fashion to receive either 20 mg/1ml of HBB i.v. or 1ml i.v. of placebo (saline). The number, size, histology and location of polyps and the occurrence of episodes of significant tachycardia (defined as bpm>140 persisting for more than 30 sec.) were recorded. The air retained in the abdomen at the end of the procedure was indirectly estimated by calculating the δAC (difference in the abdominal circumference measured before and after colonoscopy). At discharge the bloating perceived by the patient was measured by means of a VA scale (range 0-100). A sample size of at least 400 patients was calculated, by hypothesizing an increase of ADR (primary outcome measure) from 28% to 43% (α=0.05, β=0.9). Results: 402 patients (mean age 57.7+12.5 years; 44% men) were randomized to receive either HBB (202 patients) or saline (200 patients). No difference was observed as concerns polyp detection rate, ADR, advanced-ADR, mean number of polyps detected per-patient in the HBB and saline groups (see Table). Significant tachycardia was observed in 2.9% of HBB patients and in 0.5% of those receiving saline (p=ns). The δAC was similar between patients receiving HBB or saline (mean+SD 2.5+2.8 cm and 2.2+2.3 respectively; p=ns) as well as the bloating perception (VAS mean+SD 12.9+13.0 and 13.9+12.9 respectively; p=ns).Table: No Caption available.Conclusion: HBB administered before colonoscopy withdrawal phase does not increase the polyp and adenoma detection. The medication is well tolerated and it does not increase either the abdominal distension or the bloating perceived by patients at discharge.

Comparison of Meperidine Versus Hyoscine During Colonoscopy in the Elderly: A Prospective Randomized Study

Colonoscopy is the gold standard in diagnosis of diseases of the colon. Sedation and antispasmodic agents are recommended during colonoscopy. Age is a limiting factor when the surgeon is deciding whether to use these medications or not. One hundred twenty patients older than 65 years of age were randomized into two groups. The first group (n=60) received 2 mg of midazolam and 25 mg of meperidine intravenously. The second group (n=60) received 2 mg of midazolam and 20 mg of hyoscine N-butylbromide intravenously. The data collected were colonoscopy procedure time, time to cecum, visual analog pain scale, systolic blood pressure before and after the procedure, pulse, partial oxygen pressure, comfort of the endoscopist, the modified observer's assessment of alertness/sedation scale, and morbidity. Total colonoscopy and cecal reach times were shorter in Group 2 (19.58±4.82 minutes and 10.57±2.54 minutes, respectively) than in Group 1 (25.05±5.93 minutes and 13.78±3.37 minutes, respectively) (P<.001). The sedation score of Group 2 (4.52±0.50) was better than that of Group 1 (3.45±0.75) (P<.001). Nine patients (15%) in Group 1 experienced diaphoresis, temporary memory loss, or lip smacking. Three patients in Group 1 and 1 patient in Group 2 had hypoxia. Three patients in Group 1 had hypotension; this was seen in 1 patient in Group 2. One patient had perforation in Group 1. The visual analog scale score was 4.37±1.38, and the endoscopist satisfaction was 6.72±0.99 in Group 1, while these values were 3.95±0.81 and 7.75±0.89, respectively, in Group 2 (P>.05). Use of midazolam and hyoscine N-butylbromide during colonoscopy is safe in the elderly and significantly reduces procedure time while increasing comfort for the endoscopist.

Hyoscine N-butylbromide does not improve polyp detection during colonoscopy: a double-blind, randomized, placebo-controlled, clinical trial

Colonoscopy is used for the detection of neoplastic polyps, although a significant miss rate has been reported. Limited data suggest that the administration of the antispasmodic hyoscine N-butylbromide during colonoscopy improves polyp detection. To investigate whether the use of 20 mg hyoscine N-butylbromide intravenously during colonoscopy improves polyp detection or removal. A prospective, double-blind, placebo-controlled, randomized, clinical trial. Nonacademic teaching hospital. This study involved 674 patients who were routinely referred and accepted for either diagnostic or screening colonoscopy. Intravenous injection of either 1 mL hyoscine N-butylbromide (n = 340) or 0.9% NaCl solution (n = 334) when withdrawal was started. Polyp detection rate (PDR), adenoma detection rate (ADR), and the advanced lesion detection rate (ALDR), 5% trimmed mean number of polyps, mean withdrawal time. The cecal intubation rate was 96%. The PDR, ADR, and ALDR were 56% versus 60%, 30% versus 31%, and 14% versus 14% in the hyoscine N-butylbromide and placebo groups, respectively (all P values > .25). The means of the total number of detected, removed, and harvested polyps per patient were 1.13 versus 1.21, 1.03 versus 1.06, and 0.89 versus 0.89 in the hyoscine N-butylbromide and placebo groups, respectively (all P values > .37). Mean withdrawal time was 561 versus 584 seconds in the hyoscine N-butylbromide and placebo groups, respectively (P = .34). Multivariate analysis demonstrated no effect of hyoscine N-butylbromide on the investigated parameters. Only experienced colonoscopists participated in the study. We found no evidence to support the use of hyoscine N-butylbromide during withdrawal of the colonoscope to improve polyp detection or removal. ( ISRCTN25405865.).

Evaluation of the anti-peristaltic effect of glucagon and hyoscine on the small bowel: comparison of intravenous and intramuscular drug administration

To evaluate prospectively duration and effectiveness of aperistalsis achieved by glucagon(GLU) or hyoscine N-butylbromide(HBB) following various administration routes. Six volunteers underwent Magnetic Resonance Imaging (MRI) after standardized oral preparation in random order five separate MR examinations with both spasmolytic agents (HBB intravenous(i.v.) or intramuscular(i.m.), GLU i.v. or i.m., and a combined scheme). The MR protocol included a sagittal 2D cross-section of the small bowel with a temporal resolution of 0.55 s acquired over 60 to 90 min. To quantify bowel motility, small bowel cross-sectional areas were summated over time. The anti-peristaltic i.v. effects of HBB and glucagon started on average after 85 s/65 s and ended after 21 min/23.3 min, respectively. By comparison, the anti-peristaltic effects of i.m. HBB and glucagon started significantly later 5.1/11.6 min (P = 0.001; Wilcoxon signed ranks test) and lasted for 17.7/28.2 min with greater inter-individual differences (P = 0.012; Brown-Forsythe test). The combined scheme resulted in a rapid onset after 65 s with effect duration of 31 min. Anti-peristaltic effects on the small bowel are drug dependant, i.e., their onset is faster and more reliable when administering i.v. than i.m.. Combining i.v. GLU with i.m. HBB provides an early onset of effect, sustained spasmolysis and the highest degree of motility impairment. • Anti-persitaltic agents are widely used before various diagnostic procedures of the abdomen. • The combination of iv-glucagon with im-hyoscine provides reliable spasmolysis with early onset. • Intravenous spasmolysis is more reliable compared to intramuscular administration. • Intravenous glucagon has a prolonged spasmolytic effect compared to intravenous hyoscine.

Experimental and Semiempirical Investigation of Interaction Between Fast Sm Membrane Sensor and 1, 3-Di(Thiophene Imino) Benzoic Acid

This work describes, for the first time, the theoretical modeling of structure and interaction between Sm <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">3+</sup> ion and 1, 3-di(thiophene imino)benzoic acid (DTBA) as a chelating reagent in the membrane and solution which were performed using the PM6/SPARKLE semiempirical method in the MOPAC program. Computational modeling results can be predicted behavior of Sm-DTBA interactions which was used as an ionophore for construction of samarium-selective potentiometric membrane sensor. The best performance was obtained with a membrane composition of 31% (w/w) PVC, 62% tributylphosphate (TBP), 4.8% DTBA and 3.2% sodium tetraphenyl borate (NaTBP). This sensor has a Nernstian slope of 19.6 mV decade for Sm <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">3+</sup> ions in the range of 1.0 × 10 <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">-1</sup> - 5.0 × 10 <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">6</sup> M and the detection limit was 3.1 × 10 <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">-6</sup> M. The response time of the sensor is very fast (≤ 5 s) and the potentiometric response is independent of the pH of the solution in the pH range of 4.5-8.5. This sensor shows good selectivity for Sm <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">3+</sup> ion with respect to alkali, alkaline earth and heavy metal cations. The proposed sensor has been used for indirect determination of some drugs such as homatropine hydrobromide and hyoscine N-butylbromide in their pharmaceutical formulations and fluoride ions in mouthwash samples.

The absorption and elimination of orally administered [14C]hyoscine N-butylbromide (butylscopolamine)

The absorption and elimination of orally administered [14C]hyoscine <i>N</i>-butylbromide (butylscopolamine)

Efficacy of three different alpha 1-adrenergic blockers and hyoscine N-butylbromide for distal ureteral stones

To evaluate hyoscine N-butyl bromide (HBB) and three different alpha-1 blockers in the treatment of distal ureteral stones. A total of 140 patients with stones located in the distal tract of the ureter with stone diameters of 5 to 10mm were enrolled in the present study and were randomized into 4 equal groups. Group 1 received HBB, Group 2 received alfuzosin, Group 3 received doxazosin and Group 4 received terazosin. The subjects were prescribed diclofenac injection (75 mg) intramuscularly on demand for pain relief and were followed-up after two weeks with x-rays of the kidneys, ureters, bladder and urinary ultrasonography every week. The number of pain episodes, analgesic dosage and the number of days of spontaneous passage of the calculi through the ureter were also recorded. The average stone size for groups 1, 2, 3 and 4 was comparable (6.13, 5.83, 5.59 and 5.48 mm respectively). Stone expulsion was observed in 11%, 52.9%, 62%, and 46% in groups 1, 2, 3 and 4 respectively. The average time to expulsion was 10.55 ± 6.21 days in group 1, 7.38 ± 5.55 days in group 2, 7.85 ± 5.11 days in group 3 and 7.45 ± 5.32 days in group 4. Alpha blockers were found to be superior to HBB (p < 0.05). Medical treatment of distal ureteral calculi with alfuzosin, doxazosin and terazosin resulted in a significantly increased stone-expulsion rate and decreased expulsion time when compared with HBB. HBB seems to have a negative effect on stone-expulsion rate.

Effect of hyoscine-N-butyl bromide rectal suppository on labor progress in primigravid women: a randomized double-blind placebo-controlled clinical trial

AimTo determine the effects of hyoscine-N-butyl bromide (HBB) rectal suppository on labor progress in primigravid women.MethodsA randomized double-blind placebo-controlled clinical trial was carried out on 130 primigravid women admitted for spontaneous labor. The women were recruited based on the inclusion and exclusion criteria and randomized into the experimental (n = 65) and control group (n = 65). In the beginning of the active phase of labor, 20 mg of HBB rectal suppository was administered to the experimental group, while a placebo suppository was administered to the control group. Cervical dilatation and duration of active phase and second stage of labor were recorded.ResultsThe rate of cervical dilatation was 2.6 cm/h in the experimental and 1.5 cm/h in the control group (P < 0.001). The active phase and the second stage of labor were significantly shorter in the experimental group (P = 0.001 and P < 0.001, respectively). There was no significant difference between the two groups in the fetal heart rate, maternal pulse rate, blood pressure, and the APGAR score 1 and 5 minutes after birth.ConclusionUse of HBB rectal suppository in the active management of labor can shorten both the active phase and second stage of labor without significant side-effects.Registration NoIRCT138804282204N1.

Compatibility and Stability of Ternary Admixtures of Tramadol, Haloperidol, and HyoscineN-Butyl Bromide: Retrospective Clinical Evaluation

Combination of drugs for subcutaneous infusion is common practice in palliative medicine, however, there is no information pertaining to the compatibility and stability of tramadol combined in ternary admixtures and no information exists regarding its clinical performance. Tramadol hydrochloride, haloperidol lactate, and hyoscine N-butyl bromide have been examined for compatibility and stability when combined in solution under conditions mimicking their potential use via subcutaneous infusion in terminal oncology patients. Concentration ranges were 8.8-33.3 mg/mL, 0.208-0.624 mg/mL, and 3.33-6.67 mg/mL for tramadol hydrochloride, haloperidol lactate, and hyoscine N-butyl bromide. With these, 27 different admixtures were prepared and stored at 25 degrees C using 0.9% saline as diluent. Quantification was performed by high-performance liquid chromatography (HPLC). The clinical performance of the admixture was retrospectively assessed in 28 terminal oncology patients exhibiting Karnofsky's indexes of 10%-20%. All three drugs were very stable (>92%) at 25 degrees C for 15 days. Pain was completely controlled in all patients. Fifty percent of the patients suffered from 3-5 vomiting episodes per day and of these, 75% experienced complete control of the episodes. None of the patients showed local reactions after subcutaneous administration of the admixture. Our results confirm the compatibility and stability of the ternary admixture and its utility in highly vulnerable patients exhibiting moderate symptoms.

M1048 Effects of Hyoscine N-Butyl Bromide On the Detection of Polyps During Colonoscopy: A Prospective, Randomized, Double-Blind Study

M1048 Effects of Hyoscine N-Butyl Bromide On the Detection of Polyps During Colonoscopy: A Prospective, Randomized, Double-Blind Study

Role of Intravenous Hyoscine N-Butyl Bromide At the Time of Colonoscopic Withdrawal for Polyp Detection Rates: A Randomized, Double-Blinded, Placebo-Controlled Trial

Background/Aims: Colonoscopy is currently the gold standard for detection and removal of colonic neoplasia. A number of factors may contribute to the accuracy of colonoscopy. Colonic spasm is a relatively common problem, and may impede colonoscopic insertion, inspection of the mucosal surface and polypectomy. Most endoscopists perform detection and removal of colonic polyps at the time of withdrawal, and they may often feel that colonic spasm makes detection and removal of colonic polyps difficult. The aim of this study was to determine whether there was any benefit for polyp detection rates in using hyoscine N-butyl bromide (Buscopan®) at the time of colonoscopic withdrawal. Methods: We conducted a randomized double-blinded, placebo controlled trial in a single center from July 2008 to September 2008. A total of 205 patients undergoing colonoscopy were randomized to receive either 20mg of hyoscine N-butyl bromide (Buscopan group (BG), n=103) or normal saline (placebo group (PG), n=102) intravenously at the time of colonoscopic withdrawal after cecal intubation. Outcome measures included polyp and adenoma detection rate, characteristics of polyps, insertion and withdrawal time, spasm score, vital signs, and side effects. Results: There was no difference of baseline characteristics between two groups. The polyp and adenoma detection rates in the BG were some higher than the PG, but there were no significant differences between two groups (respectively, 45.6% and 35.0% vs. 39.2% and 29.4%; p=0.353 and p=0.396). The size, location, number, shape and histology of polyps and adenomas did not significantly differ between two groups. No significant difference was found in the insertion time, withdrawal time and spasm score. Blood pressure after colonoscopy was significant lower than before colonoscopy in two groups, but pulse rate after colonoscopy was significant higher than before colonoscopy in BG (p=0.000). In side effects, dry mouth was significant higher in BG than PG (p=0.013). Conclusion: Intravenously administered hyoscine N-butyl bromide at the time of colonoscopic withdrawal cannot improve polyp and adenoma detection rates.

Aperistaltic effect of hyoscine N-butylbromide versus glucagon on the small bowel assessed by magnetic resonance imaging

The aim of this prospective study was to compare the intraindividual aperistaltic effect of 40 mg hyoscine N-butylbromide (HBB/Buscopan) with that of 1 mg glucagon on small bowel motility by using magnetic resonance imaging (MRI). Ten healthy volunteers underwent two separate 1.5-T MRI studies (HBB/glucagon) after a standardized oral preparation with an aqueous solution of Gd-DOTA and ispaghula (Metamucil). A 2D T1-w GRE sequence was acquired (TR 2.7 ms/TE 1.3 ms, temporal resolution 0.25 s) before and after intravenous (i.v.) drug administration and motility was followed over 1 h. On the resulting images the cross-sectional luminal diameters were assessed and plotted over time. Baseline motility frequency, onset of aperistalsis, duration of arrest, reappearance of motility and return to normal motility were analysed. Significant differences regarding reliability and duration of aperistalsis were observed. In the HBB group aperistalsis lasted a mean of 6.8 +/- 5.3 min compared with 18.3 +/- 7 min after glucagon (p < 0.0001). In 50% of cases HBB did not accomplish aperistalsis, whereas glucagon always succeeded (p = 0.05). There were no significant differences in terms of baseline and end frequencies for the onset of aperistalsis (22.2 +/- 37.5 s HBB/13.4 +/- 9.2 s glucagon, p = 0.1), nor for the return to normal motility. Arrest of small bowel motion is achieved more reliably and lasts significantly longer after i.v. administration of 1 mg glucagon compared with 40 mg HBB.