Dose‐response relationships of intravenous hyoscine butylbromide and atropine sulphate on heart rate in healthy volunteers.

Grainger, S. L.; Smith, S. E.

doi:10.1111/j.1365-2125.1983.tb02231.x

Cited by 16 publications

(12 citation statements)

References 9 publications

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“…This probably reflects the recognised antimuscarinic properties of this drug. 12 Hyoscine butylbromide is often necessary during ERCP, but should be used in as low a dose as possible and only when really needed rather than routinely.…”

Section: Discussionmentioning

confidence: 99%

Does nasal oxygen reduce the cardiorespiratory problems experienced by elderly patients undergoing endoscopic retrograde cholangiopancreatography?

Haines¹,

Bibbey²,

Green³

1992

Gut

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Elderly patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) have an increased risk of sedation related complications during the procedure. To determine whether nasal oxygen supplementation (2 I/min) reduces these risks, half of 66 patients aged over 60 undergoing ERCP using minimal midazolam sedation alone were randomised to receive nasal oxygen. The arterial oxygen saturation and pulse rate of all patients were monitored by pulse oximetry before and during the procedure. Only three patients in the oxygen supplemented group (n=33) required any form of intervention for hypoxia compared with six in the control group (n=33). Comparison of mean arterial oxygen saturation between the groups showed significantly higher levels in the nasal oxygen group throughout the procedure. Pulse rate comparisons showed no significant difference from control group values, both groups had short periods of significant tachycardia. We conclude that minimal sedation with midazolam alone still produces hypoxia during ERCP in a substantial number of elderly patients. Nasal oxygen supplementation increases the level of patient oxygenation and reduces the need for intervention, but does not reduce tachycardia in the elderly patient. Because hyoscine may be a significant factor contributing to the tachycardia, sparing rather than routine use of this agent is advisable.

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Section: Discussionmentioning

confidence: 99%

Does nasal oxygen reduce the cardiorespiratory problems experienced by elderly patients undergoing endoscopic retrograde cholangiopancreatography?

Haines¹,

Bibbey²,

Green³

1992

Gut

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“…The reference drug, hyoscine butyibromide (40mg s.c.), which is considered as a peripheral muscarinic blocker (Grainger & Smith, 1983), since its ionized polar structure does not allow an easy crossing of the blood-to-brain barrier, produced some of the expected effects of an anticholinergic drug. Heart rate and sinus arrhythmia were affected by hyoscine butylbromide as well as salivary flow and accommodation.…”

Section: Discussionmentioning

confidence: 99%

“…A reference anticholinergic drug hyoscine butylbromide (Grainger & Smith, 1983;Herxheimer & De Groot, 1977;Herxheimer & Haefely, 1966), was selected as a positive control to assess peripheral anticholinergic activity since its polar structure does not allow the drug readily to cross the blood to brain barrier.…”

Section: Introductionmentioning

confidence: 99%

Assessment of the anticholinergic effect of the new antihistamine mizolastine in healthy subjects.

Danjou

Molinier

Berlin

et al. 1992

Brit J Clinical Pharma

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1. Twelve healthy subjects were enrolled in a double‐blind placebo controlled cross‐over study in order to assess the possible anticholinergic effects of four doses of a new antihistamine compound, mizolastine, compared with hyoscine butylbromide (HBB) used as a reference anticholinergic drug. 2. Although mizolastine, a potent and selective H1‐receptor blocker has no affinity for muscarinic receptors and does not antagonize the effects of carbachol in rodents, a study was initiated to investigate its effects on various effectors possessing muscarinic receptors (eye, heart, sweat gland, salivary gland). 3. HBB (40 mg, s.c.) impaired accommodation, decreased salivary flow and inhibited cardiac sinus arrhythmia. Pupil diameter and maximum constriction speed, carbachol‐induced skin sweating and Valsalva ratio were unaffected. 4. Mizolastine (5, 10, 20, 40 mg p.o.) did not affect any parameter at any time point, demonstrating a lack of anticholinergic effect.

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“…Although hyoscine is considered a relatively safe medication [35,36] , Marshall et al [21] reported patients who developed sinus [28] used a slightly higher dose (40 mg) compared to other studies. However, it this study was removed, the results were unchanged.…”

mentioning

confidence: 98%

Hyoscine for polyp detection during colonoscopy: A meta-analysis and systematic review

Ashraf

Siddique

et al. 2014

WJGE

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AIM:To assess the role of hyoscine for polyp detection during colonoscopy. METHODS: Studies (randomized controlled trials orRCTs) that compared the use of hyoscine vs no hyoscine or placebo for polyp detection during colonoscopy were included in our analysis. A search on multiple databases was performed in September 2013 with search terms being "hyoscine and colonoscopy", "hyoscine and polyp", "hyoscine and adenoma", "antispasmotic and colonoscopy", "antispasmotic and adenoma", and "antispasmotic and polyp". Jadad scoring was used to assess the quality of studies. The efficacy of hyoscine was analyzed using Mantel-Haenszel model for polyp and adenoma detection with odds ratio (OR). The I 2 measure of inconsistency was used to assess heterogeneity (P < 0.05 or I 2 > 50%). Statistical analysis was performed by RevMan 5.1. Funnel plots was used to assess publication bias. RESULTS:The search of the electronic databases identified 283 articles. Of these articles, eight published RCTs performed at various locations in Europe, Asia, and Australia were included in our meta-analysis, seven published as manuscripts and one published as an abstract (n = 2307). All the studies included patients with a hyoscine and a no hyoscine/placebo group and were of adequate quality (Jadad score ≥ 2). Eight RCTs assessed the polyp detection rate (PDR) (n = 2307). The use of hyoscine demonstrated no statistically significant difference as compared to no hyoscine or placebo for PDR (OR = 1.06; 95%CI: 0.89-1.25; P = 0.51). FiveRCTs assessed the adenoma detection rate (ADR) (n = 2015). The use of hyoscine demonstrated no statistically significant difference as compared to no hyoscine or placebo for ADR (OR = 1.12; 95%CI: 0.92-1.37; P = 0.25). Furthermore, the timing of hyoscine administration (given at cecal intubation or pre-procedure) demonstrated no differences in PDR compared to no hyoscine or placebo. Publication bias or heterogeneity was not observed for any of the outcomes. CONCLUSION:Hyoscine use in patients undergoing colonoscopy does not appear to significantly increase the detection of polyps or adenomas.© 2014 Baishideng Publishing Group Inc. All rights reserved.Key words: Hyoscine; Antispasmodic; Polyp detection; Colonoscopy Core tip: Hyoscine is used in clinical practice to decrease spasms in the colon during colonoscopy in an effort to improve polyp or adenoma detection. However, this study shows that hyoscine given before the procedure or at time of cecal intubation does not improve polyp or adenoma detection.

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Dose‐response relationships of intravenous hyoscine butylbromide and atropine sulphate on heart rate in healthy volunteers.

Cited by 16 publications

References 9 publications

Does nasal oxygen reduce the cardiorespiratory problems experienced by elderly patients undergoing endoscopic retrograde cholangiopancreatography?

Does nasal oxygen reduce the cardiorespiratory problems experienced by elderly patients undergoing endoscopic retrograde cholangiopancreatography?

Assessment of the anticholinergic effect of the new antihistamine mizolastine in healthy subjects.

Hyoscine for polyp detection during colonoscopy: A meta-analysis and systematic review

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