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Objective: The purpose of this article is to evaluate the efficacy of IV hyoscine butylbromide as a bowel relaxant and automated carbon dioxide insufflation in CT colonography in terms of colonic distention and perceived burden. SUBJECTS AND METHODS; Two hundred twenty-four participants were randomly allocated to one of four groups: control (no bowel relaxant and IV saline placebo before CT colonography with manual carbon dioxide insufflation), hyoscine butylbromide (IV hyoscine butylbromide before examination with manual carbon dioxide insufflation), automated (no bowel relaxant before examination with automated carbon dioxide insufflation), and combined (hyoscine butylbromide before examination with automated carbon dioxide insufflation). The degree of colonic distention on a 4-point scale, examination time, and participants' satisfaction, as measured by their responses to a questionnaire, were assessed., Results: The mean distention grades of all the colonic segments and both positions were 3.22 in the control group, 3.28 in the hyoscine butylbromide group, 3.77 in the automated group, and 3.74 in the combined group. Compared with manual carbon dioxide insufflation, automated carbon dioxide insufflation significantly improved the clinical adequacy of colonic distention and shortened examination time. No statistically significant difference was seen in the clinical adequacy of distention between participants who received hyoscine butylbromide and those who did not, or in examination time. Overall, the participants' experiences were not different., Conclusion: Colonic distention was statistically significantly improved by automated carbon dioxide insufflation, but not by the administration of hyoscine butylbromide. The participants' tolerance was similar in each group.

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 meta-analysis 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 fixed-effects 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 whom 948 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.

Background: Renal colic is typically characterized by the sudden onset of severe pain radiating from the flank to the groin and its acute management in emergency departments essentially aims at rapid pain relief. Spasmofen(®) is a brand of Amriya Pharmaceutical Industries in the form of rectal suppositories containing ketoprofen 100 mg and hyoscine butylbromide 10 mg. This combination is intended for the rapid relief of severe colicky pain in the renal system, hepatobiliary system, or gastrointestinal tract. This trial aims to compare a single-dose of Spasmofen rectal suppository to a single intravenous (IV) ketorolac tromethamine 30 mg/2 mL dose in patients with acute renal colic., Methods: A total of 80 eligible consecutive patients presenting to the emergency departments of two medical centers with acute renal colic were included in the study. Eligible patients who signed the informed consent were randomly assigned into two treatment groups: an experimental group (Spasmofen group) who received one Spasmofen rectal suppository plus an IV injection of 2 mL of normal saline solution; and a control group (ketorolac group) who received one ketorolac 30 mg/2 mL ampoule IV plus one placebo suppository. Treatment success, defined as a change in the verbal rating score from severe or moderate pain to none or mild at 60 minutes after the dose, was compared between groups using the chi-square/Fisher's exact test. Percentage reductions in visual pain analog scale (VPAS) scores at 15 and 60 minutes after the dose were compared between groups using the Z-test for proportions., Results: Successful treatment at 60 minutes occurred in 35 of 40 (87.5%) of Spasmofen-treated patients and in 33 of 40 (82.5%) of ketorolac-treated patients. The difference was not statistically significant by Fisher's exact test (P=0.755). The mean percentage reduction of VPAS after 15 minutes was 61.82% in the Spasmofen-treated group and 64.76% in the ketorolac-treated group. The difference was also not statistically significant by the Z-test for proportions (P=0.795). Sixty minutes after being treated, Spasmofen was associated with a statistically significant greater reduction in VPAS (mean% reduction =92.36%) than ketorolac (75.06%; P=0.0466)., Conclusion: Single-dose Spasmofen rectal suppository might be a safe and effective first-aid treatment for the emergency department relief of acute renal colic.

Background: Prolonged labor is one of the most important risk factors for perinatal compromise and, if caused by obstructed labor, it carries the risk of uterine rupture, postpartum hemorrhage (PPH), puerperal sepsis, and maternal death., Objective: To determine whether or not hyoscine butylbromide shortens the stages of labor, without an increase in maternal or neonatal complications., Method: In single-blinded randomized clinical trial study, 188 multiparas women in active phase of labor who were admitted to Shahid Sadoughi Hospital from October 2006 to April 2007 in Yazd - Iran, were evaluated. They were divided hyoscine group (n = 94) received 20mg (1ml) of hyoscine and control group (n = 94) received 1 ml of normal saline was given as placebo, intravenously. The effects of hyoscine in shortening labor time; and neonatal Apgar score was compared., Results: Duration of the first (mean± SD: 186.8 ± 125.6 minutes vs. 260.4 ± 120.9 minutes, p= 0.00 1) and second stage of labor (mean± SD: 20.0 ± 8.1minutes vs. 25.8 ± 9.4 minutes, p= 0.03) was shorter in hyoscine group. Frequency of cesarean section and mean of neonatal Apgar score at minutes of one and 5 were not different in both groups. No serious adverse events were seen in the two groups., Conclusion: Injection of hyoscine in active phase of labor can be effective in shortening of labor without any adverse effect on mother and fetus.

Background and Objectives: Hyoscine butylbromide (HBB) is widely used in labor rooms. There have been many studies on the use of HBB during labor with conflicting results, involving both primiparous and multiparous women. The aim of this trial was to study the efficacy of HBB for shortening the first stage of labor in primiparous women., Methods: The study was a randomized, double blind, controlled trial. Ninety-seven primigravid term pregnant women in spontaneous labor received either hyoscine butylbromide or a placebo intramuscularly once the women entered the active phase of labor. The primary outcome measured was the duration of the first stage of labor. Secondary outcomes were the duration of the second and third stages of labor, blood loss at delivery, rate of cesarean section, and Apgar scores for the neonates., Results: A total of 97 women yielded data for analysis. Of these, 45 women received the placebo and 52 received HBB. The mean duration of the first stage in the control group was 215 minutes, compared with 165 minutes in the study group, representing a decrease of 23.3% (P = 0.001). There were no significant changes in the duration of the second (P = 0.063) or third (P = 0.0418) stages of labor, and no significant differences in blood loss or Apgar scores. There was a slightly higher (but statistically insignificant) rate of instrumental delivery in the control group, but no difference in the Cesarean section rate. There was a 60% reduction in opioid analgesic use in the HBB group., Conclusion: HBB is effective in significantly reducing the duration of the first stage of labor, and is not associated with any apparent adverse maternal or neonatal outcomes.