Diclofenac versus combination of dexketoprofen and hyoscine N-butyl bromide in the treatment of renal colic in the emergency room setting: A single-blinded randomized controlled trial in a tertiary government hospital in the Philippines

INTRODUCTION@#Renal colic pain is a very severe pain usually being consulted at the emergency room.New pain relievers together with combination of other drugs is used for symptomatic relief. Thisstudy compared the efficacy and tolerability of Diclofenac versus Dexketoprofen with Hyoscine N-butyl bromide (HNBB) in the management of acute renal colic at the emergency room.@*METHODOLOGY@#This was a single blind, randomized prospective study done from June 1, 2017 toAugust 31, 2017 at the emergency department of the Jose Reyes Memorial Medical Center. Allocationand randomization were done into two treatment groups: the Diclofenac and Dexketoprofen + HNBB.Subjectivity of pain relief was based using visual analogue score (VAS), this was taken before thetreatment and 15, 30 and 60 minutes after administration of treatment.@*RESULTS@#Twenty nine (29) patients were grouped into two: Dicloenac group (n=15) and Dexketoprophen+ HNBB group (n= 14). Pain reduction in the combination group had a faster pain relief compared toDiclofenac alone with a 41% and 17% decline, respectively. The study showed that a faster pain reliefwas achieved with the Dexkoprophen + HNBB combination compared to Diclofenac alone.@*CONCLUSION@#Timing and onset of pain control in patients presenting with renal colic pain is essentialin the emergency room setting to provide adequate relief. The use of the combination therapy ofDexkotoprofen + HNNB may have a significant advantage in terms of rapid onset of relief.

Simultaneous Determination of Hyoscine N- Butyl Bromide and Paracetamol by RP-TLC Spectrodensitometric Method.

Aims: A simple RP-TLC Spectrodensitometric method was developed for determination of Hyoscine N-Butyl Bromide (HBB) and Paracetamol (PAR) either in bulk powder or in their pharmaceutical preparation. Study Design: Validation study. Methodology: In this method, HBB and PAR were separated on RP-18 W/ UV254 TLC plates using developing mobile phase consisting of methanol: citrate buffer (pH=1.5): triflouroacetic acid (70:30:0.1, by volume) at room temperature. Experimental conditions such as band size, slit width, different developing systems and scanning wavelength were carefully studied and the optimum conditions were selected. The obtained bands were then scanned at 210 nm. The two drugs were satisfactorily resolved with RF 0.60 ± 0.02 for HBB and 0.81 ± 0.02 for PAR. The validation of spectrodensitometric method was done regarding linearity, accuracy, precision, and specificity. Results: Linearity of the proposed methods was evaluated and it was found to lie within the concentration range of 2.0-12.0 μg.band-1 for HBB and 2.0-14.0 μg.band-1 for PAR. Conclusion: The proposed method was successfully applied for determination of HBB and PAR in pure form and in their different pharmaceutical formulations. The method proved to be specific, accurate and selective.

Efficacy of three different alpha 1-adrenergic blockers and hyoscine N-butylbromide for distal ureteral stones

PURPOSE: To evaluate hyoscine N-butyl bromide (HBB) and three different alpha-1 blockers in the treatment of distal ureteral stones. MATERIALS AND METHODS: A total of 140 patients with stones located in the distal tract of the ureter with stone diameters of 5 to 10mm were enrolled in the present study and were randomized into 4 equal groups. Group 1 received HBB, Group 2 received alfuzosin, Group 3 received doxazosin and Group 4 received terazosin. The subjects were prescribed diclofenac injection (75 mg) intramuscularly on demand for pain relief and were followed-up after two weeks with x-rays of the kidneys, ureters, bladder and urinary ultrasonography every week. The number of pain episodes, analgesic dosage and the number of days of spontaneous passage of the calculi through the ureter were also recorded. RESULTS: The average stone size for groups 1, 2, 3 and 4 was comparable (6.13, 5.83, 5.59 and 5.48 mm respectively). Stone expulsion was observed in 11 percent, 52.9 percent, 62 percent, and 46 percent in groups 1, 2, 3 and 4 respectively. The average time to expulsion was 10.55 ± 6.21 days in group 1, 7.38 ± 5.55 days in group 2, 7.85 ± 5.11 days in group 3 and 7.45 ± 5.32 days in group 4. Alpha blockers were found to be superior to HBB (p < 0.05). CONCLUSIONS: Medical treatment of distal ureteral calculi with alfuzosin, doxazosin and terazosin resulted in a signi?cantly increased stone-expulsion rate and decreased expulsion time when compared with HBB. HBB seems to have a negative effect on stone-expulsion rate.

A Clinical Usefulness of Premedication with Hyoscine N-butyl Bromide in Colonoscopy / 대한소화기내시경학회지

BACKGROUND/AIMS: We conducted a prospective, randomized, double-blinded, placebo-controlled trial to investigate the effect of hyoscine-N-butyl bromide during colonoscopy. METHODS: A total of 133 patients undergoing colonoscopy were randomized to receive either 20 mg of hyoscine-N-butyl bromide (n=70) or normal saline solution (n=63) via intramuscular injection as premedication. RESULTS: The mean cecal intubation time and withdrawal time in the hyoscine-N-butyl bromide group were significantly shorter than those of the control group (5.26+/-2.78 min vs. 6.74+/-4.89 min; p=0.032, 5.42+/-1.54 min vs. 6.18+/-2.54 min; p=0.038, each). The spasm grade in the hyoscine-N-butyl bromide group was significantly lower than that of the control group (p<0.001). No significant differences were found in the polyp detection rate (15.7% vs. 28.6%; p=0.073) and adenoma detection rate (10.0% vs. 15.9%; p=0.311). Difficulty of colonoscopy for the endoscopists and nurses (p=0.853; p=0.732), the patient's comfort (p=0.891) and the patient's willingness to repeat colonoscopy (85.7% vs. 82.5%; p=0.932) were also similar in both groups. CONCLUSIONS: Premedication with intramuscularly administered hyoscine-N-butyl bromide do not demonstrate any additional benefits except reducing the colonoscopy insertion time.