Yoong K Y, Perkin D, Portal J, Strickland I, Heymann T
Kingston Hospital NHS Trust, Kingston upon Thames, Surrey, UK.
Endoscopy. 2004 Aug;36(8):720-2. doi: 10.1055/s-2004-825660.
There is wide variation in the use of antispasmodics to facilitate colonoscopy, both within and between countries, and its use before such procedures remains controversial. The aim of this study was to determine whether there was any objective benefit in using hyoscine as a premedication for colonoscopy in a district general hospital.
Consecutive day-case patients undergoing colonoscopy were included in the study. They were prospectively randomly allocated to receive either intravenous hyoscine (n = 61) or intravenous placebo (n = 56) as part of their premedication.
Our analysis demonstrated no statistically significant difference between the two groups with respect to the median time from colonoscope insertion to caecal intubation (9.7 minutes in the hyoscine group vs. 8.3 minutes in the placebo group) or the median total procedure time (14.8 minutes in the hyoscine group vs. 13.8 minutes in the placebo group). There was also no statistically significant difference in success rates for caecal intubation between the two groups ( P < 0.06). However a type II error cannot be excluded because of the small sample size.
This study demonstrated no obvious benefit in the routine use of hyoscine as a premedication for colonoscopy in a district general hospital setting.
在各国国内以及不同国家之间，用于辅助结肠镜检查的解痉药使用情况差异很大，并且在这类检查前使用解痉药仍存在争议。本研究的目的是确定在一家地区综合医院中，使用东莨菪碱作为结肠镜检查术前用药是否有任何客观益处。
纳入连续接受结肠镜检查的日间手术患者。他们被前瞻性随机分配，作为术前用药的一部分，分别接受静脉注射东莨菪碱（n = 61）或静脉注射安慰剂（n = 56）。
我们的分析表明，两组之间在从插入结肠镜到盲肠插管的中位时间（东莨菪碱组为9.7分钟，安慰剂组为8.3分钟）或总操作中位时间（东莨菪碱组为14.8分钟，安慰剂组为13.8分钟）方面无统计学显著差异。两组之间盲肠插管成功率也无统计学显著差异（P < 0.06）。然而，由于样本量小，不能排除II类错误。
本研究表明，在地区综合医院环境中，常规使用东莨菪碱作为结肠镜检查术前用药没有明显益处。
