Hyoscine N-butylbromide for adenoma detection during colonoscopy

A randomized, double-blind, placebo-controlled study

Emanuele Rondonotti, Franco Radaelli, Silvia Paggi, Arnaldo Amato, Gianni Imperiali, Vittorio Terruzzi, Giovanna Mandelli, Nicoletta Lenoci, Natalia L. Terreni, Alessandra Baccarin, Giancarlo Spinzi

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background: Hyoscine N-butylbromide (HBB), commonly used during colonoscopy to facilitate cecal intubation, has been proposed to increase the adenoma detection rate (ADR). Aims: To evaluate whether HBB administration increases the adenoma detection rate and influences patients' tolerance. Methods: Consecutive colonoscopy outpatients were randomized after cecal intubation to receive either 20. mg 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). Results: 402 patients (44% male; mean age 57.7. ±. 12.5. years) 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). Conclusions: 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.

Original languageEnglish
Pages (from-to)663-668
Number of pages6
JournalDigestive and Liver Disease
Volume45
Issue number8
DOIs
Publication statusPublished - Aug 2013

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Butylscopolammonium Bromide
Colonoscopy
Adenoma
Placebos
Intubation
Colonoscopes
Visual Perception
Polyps
Abdomen
Histology
Outpatients
Air

Keywords

  • Adenoma detection
  • Colonoscopy
  • Hyoscine N-butylbromide

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Rondonotti, E., Radaelli, F., Paggi, S., Amato, A., Imperiali, G., Terruzzi, V., ... Spinzi, G. (2013). Hyoscine N-butylbromide for adenoma detection during colonoscopy: A randomized, double-blind, placebo-controlled study. Digestive and Liver Disease, 45(8), 663-668. https://doi.org/10.1016/j.dld.2013.01.029

Hyoscine N-butylbromide for adenoma detection during colonoscopy : A randomized, double-blind, placebo-controlled study. / Rondonotti, Emanuele; Radaelli, Franco; Paggi, Silvia; Amato, Arnaldo; Imperiali, Gianni; Terruzzi, Vittorio; Mandelli, Giovanna; Lenoci, Nicoletta; Terreni, Natalia L.; Baccarin, Alessandra; Spinzi, Giancarlo.

In: Digestive and Liver Disease, Vol. 45, No. 8, 08.2013, p. 663-668.

Research output: Contribution to journalArticle

Rondonotti, E, Radaelli, F, Paggi, S, Amato, A, Imperiali, G, Terruzzi, V, Mandelli, G, Lenoci, N, Terreni, NL, Baccarin, A & Spinzi, G 2013, 'Hyoscine N-butylbromide for adenoma detection during colonoscopy: A randomized, double-blind, placebo-controlled study', Digestive and Liver Disease, vol. 45, no. 8, pp. 663-668. https://doi.org/10.1016/j.dld.2013.01.029
Rondonotti, Emanuele ; Radaelli, Franco ; Paggi, Silvia ; Amato, Arnaldo ; Imperiali, Gianni ; Terruzzi, Vittorio ; Mandelli, Giovanna ; Lenoci, Nicoletta ; Terreni, Natalia L. ; Baccarin, Alessandra ; Spinzi, Giancarlo. / Hyoscine N-butylbromide for adenoma detection during colonoscopy : A randomized, double-blind, placebo-controlled study. In: Digestive and Liver Disease. 2013 ; Vol. 45, No. 8. pp. 663-668.
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abstract = "Background: Hyoscine N-butylbromide (HBB), commonly used during colonoscopy to facilitate cecal intubation, has been proposed to increase the adenoma detection rate (ADR). Aims: To evaluate whether HBB administration increases the adenoma detection rate and influences patients' tolerance. Methods: Consecutive colonoscopy outpatients were randomized after cecal intubation to receive either 20. mg 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). Results: 402 patients (44{\%} male; mean age 57.7. ±. 12.5. years) 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). Conclusions: 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.",
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AU - Terruzzi, Vittorio

AU - Mandelli, Giovanna

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AU - Baccarin, Alessandra

AU - Spinzi, Giancarlo

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