No evidence for the use of buscopan (hyoscine butylbromide) in renal colic
Date First Published:
July 31, 2001
Last Updated:
November 17, 2003
Report by:
Kevin Mackway-Jones, Consultant in Emergency Medicine (Manchester Royal Infirmary)
Search checked by:
Stewart Teece, Manchester Royal Infirmary
Three-Part Question:
In [a patient with renal colic] is [buscopan (hyoscine butylbromide) better than analgesics] at [controlling pain]?
Clinical Scenario:
A 38 year old man presents with moderate to severe left sided renal colic. He is known to suffer from renal stones. Examination reveals mild loin tenderness and there is blood in the urine. Oral analgesia seems unlikely to control his pain. You speak to a colleague who suggests that you use buscopan (hyoscine butylbromide) - an antispasmodic. You wonder if there is any evidence that this works.
Search Strategy:
Medline 1966-10/03 using the OVID interface on ATHENS including non-indexed citations and Medline in progress
Search Details:
([exp kidney calculi OR exp kidney diseases OR exp ureteral calculi} AND {exp pain OR ache$.mp OR pain$.mp OR exp colic OR colic.mp}] OR renal colic.mp) AND {exp butylscopolammonium bromide OR buscopan.mp OR exp scopolamine or hyoscine.mp OR exp scopolamine derivatives OR hyoscine butylbromide.mp} LIMIT to human and english language.
Outcome:
6 papers found of which 1 was relevant.
Relevant Paper(s):
| Study Title | Patient Group | Study type (level of evidence) | Outcomes | Key results | Study Weaknesses |
|---|---|---|---|---|---|
| Intravenous tenoxicam to treat acute renal colic: comparison with buscopan compositum. al-Waili NS, Saloom KY. 1998, UAE | 47 patients with acute renal colic Tenoxicam 25mg vs buscopan compositum |
PRCT | Improvement in pain at 1 hr | 80% for tenoxicam vs 72.7% for buscopan | Small numbers |
| Relapse within 24 hrs | 0% for tenoxicam vs 62% for buscopan |
Author Commentary:
There is only one small study in this area.
Bottom Line:
Buscopan is less effective than non-steroidal antiinflammatory agents in renal colic.
Level of Evidence:
Level 3: Small numbers of small studies or great heterogeneity or very different population
References:
- al-Waili NS, Saloom KY.. Intravenous tenoxicam to treat acute renal colic: comparison with buscopan compositum.