Introduction The routine use of hyoscine as premedication in colonoscopy has been much debated with varying practice throughout the UK. Earlier studies reported quicker intubation times and even improved ileal intubation rates with others, showing no effect.1 ,2 The aim of this study was to determine the effect on caecal intubation rate and time with use of hyoscine as premedication during diagnostic colonoscopy.
Methods 115 consecutive patients undergoing routine diagnostic colonoscopy performed by a single endoscopist were recruited in a teaching hospital setting. Age and sex matched patients (67 male and 68 female) were randomised to receive either intravenous 20 mg hyoscine (n=59) or 5 ml normal saline (n=56) as part of their premedication.
Result Although median time to caecum was shorter in the hyoscine group, this was not statistically significant (p=0.25); (adjusted for age, sex, number of operations and type of instrument used (standard Olympus CF240L vs variable stiffness CF 240DL)). Similarly, adjusted caecal intubation rates were not significantly different between the two groups. In the hyoscine group, there were three failed completion colonoscopy due to impassable sigmoid stricture (one malignant). Withdrawal times were similar in both groups (9.2±2.0) min.
|Group n=115||Placebo; n=56||Hyoscine; n=59|
|Caecal intubation time (min)||8.8±4.7||8.0±2.9|
|Caecal intubation rate (%)||100||95|
|Terminal ileal intubation (%)||73||60|
|Mean dose of Midazolam (mg)||2.7±0.6||2.8±0.6|
|Mean dose of Pethidine (mg)||29±9.0||26±5.8|
Values are mean with standard deviation
Conclusion Premedication with hyoscine does not appear to affect caecal intubation times or rates in diagnostic colonoscopy. There was a trend towards improved ileal intubation rate in the placebo group but this was not statistically significant.
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