Kolonoskopi öncesi premedikasyon olarak hyoscine n-butylbromide kullanımının etkisi

Amaç: Kolonoskopi öncesi premedikasyon olarak antispasmodik uygulanmasının işlemi kolaylaştırıp kolaylaştırmadığı tartışmalı bir konudur. Bu çalışmada kolonoskopi öncesi hyoscine n-butylbromide kullanımının ağrı, total işlem zamanı ve çekal intübasyon hızı üzerine etkisinin araştırılması amaçlanmıştır. Yöntem: Kolonoskopik girişim gerektiren 74 hasta randomize olarak 2 gruba ayrıldı (n=37). Birinci gruptaki hastalara premedikasyon olarak 1 ml serum fizyolojik, ikinci gruptaki hastalara ise 20 mg/1 ml hyoscine n-butylbromide işlemden 20 dakika önce uygulandı. Biyopsi ya da polipektomi gibi girişim gerektiren birinci gruptaki 11 hasta ile ikinci gruptaki 10 hasta çalışmadan çıkarıldı. Total işlem zamanı ve çekal girişim olup olmadığı kaydedildikten sonra hastalardan 100 mm visual analog skala (VAS) yardımı ile işlem sırasındaki ağrıyı tanımlaması istendi. Bulgular: Ortalama işlem zamanı grup 1’de 29.1±5.2 dk iken grup 2’de 30.4±6.7 dk olarak saptandı (P=0.436). Kontrol grubunda 2 (% 7.6), premedikasyon grubunda 1 hastada (% 3.7) çekal girişim yapılamadı (P=0.978). Kontrol grubunda ortalama VAS skoru 61.3±22.1 iken, premedikasyon grubunda 49.5±21.4 olarak bulundu (P=0.047). Sonuç: Kolonoskopi öncesinde hyoscine n-butylbromide kullanımı total işlem zamanı ve çekal girişim hızına bir etkisi olmamasına rağmen hastalar tarafından tanımlanan ağrı hissini azaltmaktadır.

Anahtar Kelimeler:

Kolonoskopi, Premedikasyon, Bütilskopolamoyum bromid, Parasempatolitikler, Ağrı ölçümü

The effect of hyoscine n-butylbromide as premedication before colonoscopy

Objective: Application of antispasmodic before colonoscopy is still a debate matter. This study was aimed to detect the effect of hyoscine n-butylbromide as premedication before colonoscopy on pain score, total procedure time and caecal access rate. Methods: Seventy four patients who underwent colonoscopic examination were randomly divided into two groups. Twenty minutes before colonoscopy, 1 ml serum physiologic to group 1 and 20 mg/1 ml hyoscine n-butylbromide to group 2 were administered intramuscularly. Eleven patients from group 1 and 10 from group 2 who required biopsy or polypectomy were excluded from the study. After documentation of total procedure time and caecal access was positive or not, the patients were requested to evaluate the pain during procedure by using 100 mm visual analogue scale (VAS). Results: While mean procedure time was 29.1±5.2 min in group 1, it was 30.4±6.7 min in group 2 (P=0.436). The caecal access can not be performed in 2 patients in group 1 (7.6%) and in 1 patient in group 2 (3.7%) (P=0.978). Mean VAS score was 61.3±22.1 in group 1 and 49.5±21.4 in group 2 (p=0.047). Conclusion: Application of hyoscine n-butylbromide as premedication before colonoscopy do not affect the total procedure time and caecal access rate. However, it significantly reduce the pain score described by the patients.

Keywords:

Colonoscopy, Premedication, Butylscopolammonium Bromide, Parasympatholytics, Pain Measurement,

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