Do you use Buscopan for acute abdominal pain ? Buscopan (Hyoscine-N-butylbromide) 20 mg in ampoule is an antispasmodic agent, relaxing smooth muscles of the hollow viscus in the abdomen and pelvic cavities; mainly via the intra-mural parsympathetic ganglia. It is indicated to relieve spasm in biliary or renal colic. It is commonly used to relieve the muscle spasm related to severe gastritis, but this is not a well-accepted indication in most current drug information directories. But, it is NOT, a super-drug, used for all patients presenting with acute abdominal pain. Here, the current practice of Buscopan first in all acute abdomen must be condemned. It has no use whatsoever in acute appendicitis, mesenteric ischaemia, acute intestinal obstruction, dissecting aneurysms, perforated ulcers etc etc; in fact, it may mask the early signs and thus delay definitive treatment. So, drop the thought of lets give him Buscopan and see what happens ! Problem is that Buscopan worsens some common conditions; tachycardia becomes worse, urinary retention is likely, acute angle closure glaucoma may be exacerbated. So, lets look at the scenario of an elderly gentleman brought into the ED with severe upper abdominal pain; vague symptoms and location of pain. ED doc now scratches his head and thinks ......ummmm ...... lets give Buscopan and see what happens. [wrong move here doc. biliary and renal colic aint the likely problem] Buscopan given. Patient observed. Pain persisting (no surprise here!). Patient now feels palpitations due to the induced tachycardia. Worse he cant seem to be able to pee (from the urinary retention). He starts feeling more breathless from all the additional work that his heart is doing. Pain worsens, anxiety kicks in, tachycardia increases, breathlessness much worse. Doesnt this begin to look like a vicious cycle to you ? Is it a surprise that this patient collapses in a few hours ? All from one simple injection of Buscopan. So, Buscopan is really really not to be used in all acute abdomens; only in that small number where it is caused by biliary / renal colic and probably GI spasms from gastritis and too much nasi kandar-itis ! When using Buscopan, we must watch out for the following IV Buscopan must be given as SLOW bolus; reports of deterioration of BP and shock following rapid IV bolus are fairly common. All patients given IM / IV Buscopan must be observed for at least 30 minutes
Posted on: Wed, 24 Sep 2014 20:53:11 +0000
Trending Topics
Recently Viewed Topics
© 2015