PREMEDICATION WITH INTRAVENOUS ANTISPASMODIC SPEEDS COLONOSCOPE INSERTION

Background: Use of antispasmodic medication prior to colonoscopy is co ntroversial but may improve visualization of colonic mucosa and ease c olonoscope insertion. Method: The effects on the performance of colono scopy by premedication with the antispasmodic hyoscine n-butyl bromide were studied in a prospective, double-blind, placebo-controlled trial . Fifty-six consecutive patients were randomly assigned to receive int ravenous hyoscine 20 mg (n = 29) or placebo (n = 27) in conjunction wi th our standard initial medications (meperidine 0.7 mg/kg and midazola m 0.03 mg/kg). Insertion and withdrawal of the colonoscope were timed, and 100 mm visual analogue scales were used to assess procedure diffi culty, colonic motility, and the degree of discomfort experienced by t he patients. Results: In those patients receiving hyoscine, intubation time was quicker (median hyoscine, 13 minutes; median placebo, 17.5 m inutes, p = 0.045) and colonic spasm less (median hyoscine, 19 mm; med ian placebo, 53.5 mm, p = 0.01). The procedure was considered signific antly less difficult in the hyoscine group (median, 23.5 mm) compared to the placebo group (median, 50), p < 0.05. No significant difference s in withdrawal time or patient pain scores were found. Conclusions: P remedication with intravenous hyoscine n-butyl bromide reduces colonic spasm and in this study made colonoscope insertion significantly quic ker and easier.