Effect of Hyoscine N-butylbromide on Polyp Detection During Colonoscopy: A Meta-Analysis of Randomized Controlled Trials

Abstract

AIM: Colonoscopy is widely used to detect and remove adenomatous polyps. The missing rate of polyp using colonoscopy to detect colorectal diseases is significantly high. It is still controversial whether the use of antispasmodic drug hyoscine N-butylbromide (Buscopan) would enhance polyp detection using colonoscopy. MATERIALS AND METHODS: In order to evaluate the efficacy and safety of antispasmodic drug hyoscine N-butylbromide in the detection and removal of adenomatous polyps using colonoscopy, we conducted a comprehensive strategy across various databases, and performed a meta-analysis on selected studies, according to the Cochrane Handbook (version 5.1.0). RESULTS: Five randomized controlled trials (RCTs) incorporating 1006 subjects in the Buscopan-group and 992 subjects in the placebo-group were included in this meta-analysis. We found no significant difference between these two groups in polyp detection rate (PDR) (RR 1.05, 95% CI:0.95-1.15, P=0.33), the adenoma detection rate (ADR) (RR 1.09, 95% CI:0.94-1.26, P=0.24), the advanced adenoma detection rate (A-ADR) (RR 0.91,95% CI:0.66-1.25, P=0.57), the mean number of polyp detected per patient (MPP) (weighted mean difference p=0.35, 95% CI:-0.05-0.13, P=0.35), and adverse events-Tachycardia (RR 4.94, 95% CI:0.86-28.33, P=0.07) . CONCLUSION: Buscopan administered intravenously at time of cecal intubation does not improve PDR, ADR, A-ADR, and MPP, according to the five analyzed studies. The drug doesn’t lead to obvious adverse events. Further research is required to determine whether the decrease in colonic spasms would affect polyp detection, and which specific patient populations may benefit from buscopan administration.