Does hyoscine butylbromide really improve polyp detection during colonoscopy? A meta-analysis of randomized controlled trials

AIM:To investigate the benefits of hyoscine butylbromide in polyp detection during colonoscopy by a meta-analysis of available randomized controlled trials(RCTs).METHODS:Databases,including PubMed,EMBASE,the Cochrane Library,and the Science Citation Index up to September 2013,were searched.The primary outcome was polyp detection rate,and the secondary outcome was adenoma detection rate.The metaanalysis was performed using the free software Review Manager.Differences observed between the treated and the control groups were expressed as odds ratio(OR)with a 95%confidence interval(CI).A fixedeffects model was used to pool data when statistical heterogeneity was absent.If statistical heterogeneity was present(P<0.05),a random-effects model was used.RESULTS:The initial search identified nine articles.After screening,five RCTs with a total of 1998 patients were included in this meta-analysis.Of the five studies,all described a comparison of baseline patient characteristics and showed that there was no statistically significant difference between the two groups.Among the 1998 patients,1006 received hyoscine butylbromide and 992 were allocated to the control group,and the polyp detection rate was reported.There were no significant differences between the treated and the control group(OR=1.09,95%CI:0.91-1.31,P=0.33).Four RCTs included 1882 patients,of whom948 received hyoscine butylbromide,and the adenoma detection rate was reported.There were no significant differences between the treated and the control group(OR=1.13,95%CI:0.92-1.38,P=0.24).CONCLUSION:The use of hyoscine butylbromide did not significantly improve the polyp detection rate during colonoscopy.

The effect of administrating hyoscine bromide on pregnancy rate before embryo transfer in ART cycles

Assisted reproductive technology methods i.e., IVF and ICSI were extensively used for treatment of infertility. Although, these methods have many advantages but ART pregnancy rate remains low (30% - 35%). It seems that uterine peristalsis occurred after rhCG administration in turn resulting to impair implantation of the transferred embryos. Therefore this study was conducted to possess of whether hyoscine bromide can effectively alleviate uterine contraction and then have any effect on the reproductive outcome. Healthy women who underwent IVF or ICSI cycles (n = 142) were randomly assigned to one of two groups at the start of the cycle. Group control (n = 71) without applied hyoscine and group experiment (n = 71) applied hyoscine (25 mg). Controlled ovarian hyperstimulation was induced with follicle stimulating hormone (FSH). Sperm preparation and ovarian puncture for in vitro maturation and fertilization (IVF) of oocyte were carried out for 42 hours after rhCG injection. Two weeks after rhCG injection, bhCG pregnancy test to determine pregnancy outcome in both groups was done and the outcome results, along with other information were recorded separately. The pregnancy rate in experimental group was significantly higher than that of control group. when all of the cycles with or without giving 25 mg of hyosine were stratified by the mean total follicles (more/less than 2 follicles) and embryos (more/less than25 kg/m2), the Patients’ age, the quality grade of embryos and infertility duration (more/less than 5 years), the reproductive outcome, in overall, in the subjects with more than 10 oocytes, 5 embryos, more than quality A and B grades of embryos, less than 35 years age and also less than 5 years infertility duration was more pronounced than the other patients. But the other parameter was not affected by the reproductive outcome. Clinical or statistical improvement of the reproductive outcome could be demonstrated in the hyosine treated group especially with increasing the mean total follicles, embryo, quality of embryo in women with low age and infertility duration. However, further well-designed studies are essential to offer a final conclusion.

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

AIM: To assess the role of hyoscine for polyp detectionduring colonoscopy.METHODS: Studies(randomized controlled trials orRCTs) that compared the use of hyoscine vs no hyo-scine or placebo for polyp detection during colonoscopywere included in our analysis. A search on multiple da-tabases was performed in September 2013 with searchterms being "hyoscine and colonoscopy", "hyoscineand polyp", "hyoscine and adenoma", "antispasmoticand colonoscopy", "antispasmotic and adenoma", and"antispasmotic and polyp". Jadad scoring was used toassess the quality of studies. The efficacy of hyoscinewas analyzed using Mantel-Haenszel model for polypand adenoma detection with odds ratio(OR). The I2measure of inconsistency was used to assess hetero-geneity(P < 0.05 or I2 > 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 ab-stract(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 as-sessed 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). Five RCTs assessed the adenoma detection rate(ADR)(n = 2015). The use of hyoscine demonstrated no statisti-cally 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 admin-istration(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.

Effect of Hyoscine Butyl Bromide on the Course of Labour

Background: Hyoscine butyl bromide (Buscopan) is being used as an agent for reducing the duration of labour. There are however conflicting results on the effect of this agent on cervical dilation. Materials and Methods: This was an open label clinical trial of one hundred and thirty two (132) pregnant women in labour. Women were grouped to receive either 20 mg of hyoscine butyl bromide intramuscularly at the onset of active phase labour or placebo “Normal saline”. The main outcome measure was to compare the duration of first stage labour in the study and control groups as well as feto-maternal outcomes. Relevant data were collected using a proforma. The data were analysed using Statistical Package for Social Sciences (SPSS) version 20. Results: A total of 132 were randomised and 123 yielded for analysis. Of these 59 received hyoscine butyl bromide and 64 received placebo. There was no significant difference in the mean duration of active labour to second stage between the drug and placebo arms (312.5 versus 305.3 minutes, respectively, P = 0.788). The feto-maternal outcomes were similar between both arms. Conclusion: Hyoscine butyl bromide does not shorten the duration of labour in spontaneous labour. It also does not change feto-maternal outcomes.

Evaluation of the Influence of Hyoscine Butylbromide on the Oral Bioavailability of Lansoprazole in Healthy Adult Volunteers

The gastroesophageal reflux and/or peptic ulcer diseases are clinical conditions that occur usually accompanied of symptomatic pain. Lansoprazole, a proton pump inhibitor class drug is widely used in clinical practice for treatment of these diseases. However, its efficacy can be improved by combining with spasmolytic and/or visceral analgesic such as hyoscine butylbromide. Since hyoscine butylbromide is barely absorbed and exerts some local effects at gastrointestinal tract which may modify the absorption of lansoprazole, it is important to establish if there is a pharmacokinetic interaction after the oral concomitant administration of both drugs. For this objective, twenty-five subjects received under a crossover design an oral administration of lansoprazole (15 mg) plus placebo or a fixed-dose combination with hyoscine butiylbromide (15 mg + 10 mg, respectively). Plasma samples were obtained at different times during 10 hours. Lansoprazole plasma concentrations were determined by a high performance liquid chromatography method coupled to tandem mass spectrometry. Fixed-dose combination was well tolerated. Lansoprazole pharmacokinetic parameters were: Cmax 621.81 ± 212.79 and 450.38 ± 192.14 ng/mL;AUC0-t 1941.36 ± 845.57 and 1454.66 ± 757.28 ng·h/mL;tmax 2.83 ± 0.99 and 3.40 ± 1.82h;t1/2 1.35 ± 0.39 and 1.45 ± 0.51 h, for alone and combined fixed-dose formulation, respectively. Pharmacokinetic parameters were compared by analysis of variance and ratios of AUC0-t, Cmax and 90% confidence intervals obtained. Since confidence intervals exceed the 80% - 125% limits for these parameters, we conclude that there is a significantly pharmacokinetic interaction of lansoprazole when it is administered concomitantly with hyoscine butylbromide.

Determination of Hyoscine Butylbromide with Ag＋ and Dihalogenated Fluorescein Dyes in Capsules by Resonance Rayleigh Scattering Method Coupled with Flow Injection Analysis Techniquet

In pH 4.2-5.2 HOAc-NaOAc buffer solution, Ag＋ reacted with dihalogenated fluorescein （DHF） dyes to form a 1 ; 2 anionic complex. This anionic complex could further react with hyoscine butylbromide （HBB） to form 1 ： 1 ion-association complex, which resulted in the significant enhancement of resonance Rayleigh scattering （RRS） intensity. Therefore, a novel method for the determination of HBB by resonance Rayleigh scattering （RRS） coupled with flow injection analysis （FIA） technique has been established. The present method had been applied to determine HBB in capsules and the results were in good agreement with those obtained by the literature method.