Intravenous antispasmodic and patient-controlled analgesia are of benefit for screening flexible sigmoidoscopy☆,☆☆,★,★★
Section snippets
METHODS
In a double-blinded, placebo-controlled study, asymptomatic patients, ages 55 to 75 years, at average risk for cancer and undergoing screening flexible sigmoidoscopy, were randomly allocated to one of three treatment arms: (1) hyoscine (hyoscine n-butyl-bromide 20 mg i.v. plus inhaled oxygen on demand), (2) nitrous oxide (sterile water injection plus a mixture of 50% nitrous oxide and 50% oxygen inhaled on demand), or (3) placebo (sterile water injection plus inhaled oxygen on demand).
RESULTS
A total of 131 screenees who met the entry criteria were entered consecutively into the trial. Forty patients received hyoscine, 48 nitrous oxide, and 43 placebo. There were no significant differences between the profiles of the screenees in the three study groups. Subject details and endoscopic findings are displayed in Table 1.
No difference was observed between the study groups with regard to the maximum depth of insertion: for hyoscine, median depth was 60 cm and range 25 to 100 cm; for
DISCUSSION
Flexible sigmoidoscopy is a safe and relatively inexpensive procedure, performed by primary health care physicians and hospital gastroenterologists alike.1, 11 The American Cancer Society currently recommends screening by flexible sigmoidoscopy every 3 to 5 years after age 50.12 To maintain compliance with repeated screening, it is essential that the procedure be acceptable to the patient, involve a minimum of discomfort, if any, and be quick and accurate. In this study, we have assessed the
Acknowledgements
The authors would like to thank Sergeant Bernard Winter and Corporal Garath Herbert of the 2nd Parachute Regiment for their help with this study.
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2013, Colorectal Surgery, Fifth EditionNitrous oxide for analgesia in colonoscopy without sedation
2011, Gastrointestinal EndoscopyCitation Excerpt :Regarding colonoscopy, little difference was seen between the nitrous oxide groups and the control groups in the studies included.5-10 The study by Saunders et al13 was placebo controlled. Both intravenous sedation/analgesia and nitrous oxide proved favorable to placebo regarding patient-reported pain.
Sublingual hyoscyamine spray as premedication for colonoscopy: a randomized double-blinded placebo-controlled trial
2008, American Journal of SurgeryCitation Excerpt :There was no difference in terms of speed of procedure, medications required, or patient discomfort.7 In contrast to earlier studies, Saunders and Williams8 and Saunders et al9 showed benefit in 2 studies from hyoscine n-butylbromide, another antispasmodic given as premedication for colonoscopy. In the first study, 56 patients were randomly assigned to receive intravenous hyoscine or placebo before colonoscopy.
Effect of hysterectomy status on polyp detection rates at screening flexible sigmoidoscopy
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From the Department of Endoscopy and the Imperial Cancer Research Foundation, St. Mark's Hospital, London, United Kingdom; and the King Edward VII Memorial Hospital, Port Stanley, Falkland Islands.
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Reprint requests: Brian P. Saunders, MRCP, Department of Endoscopy, St. Mark's Hosptial, City Road, London, EC1V 2PS.
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Reprint requests: Brian P. Saundes, MRCP, Department of Endoscopy, St. Mark's Hospital, City Road, London, EC1V 2PS.
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