Is buscopan effective in meat bolus obstruction?

Abstract

Objective: To assess the efficacy of hyoscine butyl bromide (buscopan) in relieving oesophageal meat bolus obstruction.

Design: Retrospective review of case notes.

Setting: Secondary otorhinolaryngology care.

Participants: Twenty-nine patients who presented to the Accidents & Emergency department satisfying, inclusion criteria: (i) >or=16 years old, (ii) patients with only meat bolus obstruction and (iii) had either only buscopan or no medications. Exclusion criteria were: (i) <16 years of age, (ii) patients who received any medications other than or in addition to buscopan, (iii) other foreign body obstructions and (iv) any patient in whom the approximate time of resolution of obstruction was not documented.

Results: Twenty-nine patients with 31 episodes of obstruction were analysed. Twenty-two episodes were treated with buscopan and in 18 (82%) the obstruction was relieved. Two had spontaneous relief >24 h later and two had surgical disimpaction. In nine episodes, where no medications were given, seven (78%) cleared spontaneously and two had surgical removal. Fisher's exact test failed to show any significant difference between the two groups. The study groups were too small and power calculation showed that the number required for statistically validated result would be 140 in each group.

Conclusion: Routine use of buscopan in oesophageal obstruction especially in the upper two-thirds needs to be reviewed because of the possibility of side-effects and lack of objective evidence of its efficacy.