The effect of timing of intravenous muscle relaxant on the quality of double-contrast barium enema

AIM: To determine whether the timing of buscopan administration during doub le-contrast barium enema examination (DCBE) affects diagnostic quality. MATERIALS AND METHODS: In a prospective setting, 100 consecutive adult out- patients referred for DCBE received 20 mg buscopan (hyoscine-N-butylbromide ) intravenously, either before infusion of barium suspension (Group A) or a fter barium infusion and gas insufflation (Group B), A subjective assessmen t of ease of contrast medium infusion was made at the time of examination a nd the films subsequently analysed by two radiologists unaware of the mode of relaxant administration, who noted the quality of mucosal coating and ma de subjective and objective measurements of segmental distension. RESULTS: There was no significant difference in screening times, infusion d ifficulty or colonic contrast medium coating between the two groups, Subjec tive assessment of distension of the caecum, ascending colon, transverse co lon and rectum were not significantly different. Patients receiving intrave nous relaxant after barium and gas infusion had less subjective descending (P = 0.05) and sigmoid (P = 0.04) colon distension, but there was no signif icant difference with respect to maximal bowel diameter in any of the segme nts measured. CONCLUSION: The timing of intravenous administration during DCBE is likely to have no significant effect on the diagnostic quality of the study. Elson , E. M. et al. (2000). Clinical Radiology 55. 395-397. (C) 2000 The Royal C ollege of Radiologists.