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

Byun, Tae Jun; Han, Dong Soo; Ahn, Sang Bong; Cho, Hyun‐Seok; Kim, Tae Yeob; Eun, Chang Soo; Jeon, Yong Cheol; Sohn, Joo Hyun

doi:10.1016/j.gie.2009.03.555

Cited by 13 publications

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“…(Figure 1). Of these articles, 8 published randomized controlled trials (RCTs) performed at various locations in Europe, Asia, and Australia were included in our meta- analysis, seven published as manuscripts [17,[25][26][27][28][29][30] and one published as an abstract [24] ( Table 1). All included patients with a hyoscine and a no hyoscine/placebo group and were of acceptable quality (≥ 2 on the Jadad scale) ( Table 2).…”

Section: Discussionmentioning

confidence: 99%

“…It is associated with significantly less anticholinergic side effects due to not crossing the blood-brain barrier, making it a useful antispasmodic agent [23] . The use of hyoscine as premedication or at the time of cecal intubation during colonoscopy has shown conflicting results for detection of polyps [17,[24][25][26][27][28][29][30] . Therefore, through study of randomized controlled trials (RCTs), hyoscine was compared to no hyoscine or placebo for polyp or adenoma detection during colonoscopy.…”

Section: Introductionmentioning

confidence: 99%

“…The finding of tachycardia in these studies lead to unblinding. Byun et al [24] also reported significant incidence of dry mouth with the use of hyoscine.…”

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confidence: 95%

“…Byun et al [24] discovered no difference in polyp or ADR with more side effects with hyoscine use. Furthermore, procedure time and spasm score were not affected [24] .…”

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confidence: 98%

“…November 16, 2014|Volume 6|Issue 11| WJGE|www.wjgnet.com [26] 2012 RCT Double Netherlands 674 20 mg IV Cecal intubation Byun et al [24] 2009 RCT Double NR 205 20 mg IV Cecal intubation Lee et al [17] 2010 RCT Double NR 116 20 mg IV Cecal intubation Kim et al [27] 2010 RCT Double South Korea 133 20 mg IM Premedication Rondonotti et al [29] 2013 RCT Double Italy 402 20 mg IV Cecal intubation Mui et al [28] 2004 RCT Yes China 120 40 mg IV Premedication Saunders et al [30] 1996 RCT Yes England 56 20 mg IV Premedication Corte et al [25] 2012 RCT Yes Australia 601 20 mg IV Cecal intubation RCT: Randomized controlled trial; NR: Not reported. tachycardia with hyoscine.…”

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confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…The finding of tachycardia in these studies lead to unblinding. Byun et al [24] also reported significant incidence of dry mouth with the use of hyoscine.…”

mentioning

confidence: 95%

“…Byun et al [24] discovered no difference in polyp or ADR with more side effects with hyoscine use. Furthermore, procedure time and spasm score were not affected [24] .…”

mentioning

confidence: 98%

mentioning

confidence: 99%

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

Ashraf

Siddique

et al. 2014

WJGE

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Oral IBGard™ Before Colonoscopy: A Single-Center Double-Blinded, Randomized, Placebo-Controlled Trial

et al. 2020

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Does Hyoscine improve polyp detection rate during colonoscopy? Systematic Review & meta-analysis of randomized clinical trials

Hureibi

Abraham

Al-Sunidar

et al. 2018

Annals of Medicine and Surgery

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Background/objectivePublished studies have shown conflicting results regarding the benefit of Hyoscine Butylbrmoide use during colonoscopy in polyp and adenoma detection rates. This meta-analysis was conducted with the aim to summarize all available evidence.MethodsA literature search was carried out using PubMed, Ovid MEDLINE and the Cochrane Library database from inception to December 2017. Studies that compared the use of Hyoscine Butylbrmoide compared to placebo during colonoscopy were included. Pooled odds ratio and 95% confidence interval were calculated using Mantel-Haenszel fixed-effects model when there was no heterogeneity identified.ResultsOf the 423 retrieved studies, eight met the eligibility criteria and were included in the analysis. There was no significant difference between the groups in terms of polyp and adenoma detection rates.There was no significant difference between the Hyoscine and placebo groups in polyp detection rate (49.3% vs 48%, OR = 1.06, 95% CI: 0.90–1.23, P = 0.50). Adenoma detection rate was also not significantly different between the 2 groups 33.7% vs, 31%; OR = 1.13; 95%CI: 0.95–1.35; P = 0.16). No heterogeneity was observed (P = 0.65, I2 = 0%).ConclusionThis meta-analysis found no significant impact of Hyoscine on polyp and adenoma detection when used during colonoscopy.

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

Cited by 13 publications

References 0 publications

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

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

Oral IBGard™ Before Colonoscopy: A Single-Center Double-Blinded, Randomized, Placebo-Controlled Trial

Does Hyoscine improve polyp detection rate during colonoscopy? Systematic Review & meta-analysis of randomized clinical trials

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