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BMC Pregnancy and Childbirth May 2020The objective of this systematic review and meta-analysis was to assess the effectiveness of hyoscine n-butylbromide in labor progress. (Meta-Analysis)
Meta-Analysis
BACKGROUND
The objective of this systematic review and meta-analysis was to assess the effectiveness of hyoscine n-butylbromide in labor progress.
METHODS
The databases including PubMed, the Cochrane Library, Science-Direct, Scopus and Web of Science were searched for studies published up to December 2019. Articles that published as randomized controlled trials (RCTs), and full-text articles published in English or other languages were included and participants were primi or multigravida women who were in active phase of labor. The intervention included HBB compared to placebo (normal saline) that was used during active phase of labor. Pooled estimates were measured using the fixed or random effect model, while the overall effect was reported in a mean difference (MD). All data were analyzed using Review Manager 5.3.
RESULTS
Twenty studies involving 3108 women were included in meta-analysis. Based on subgroup analysis by parity, use of HBB significantly reduced the duration of the first stage of labor in primigravida women (MD = - 57.73; 95% CI: [- 61.48, - 53.60]) and in multigravida women (MD = - 90.74; 95% CI: [- 97.24, - 84.24]). Administering HBB could reduce the second stages of labor in primigravidas and multigravidas about 6 min and 4 min respectively. Also, HBB reduced the duration of the third stage of labor in multigravidas about 3 min. APGAR score at one and 5 min after birth was not affected. The main maternal adverse effect was tachycardia and dry mouth. Labor duration in studies in which the participants were primi-and multigravida was not presented based on separate parities except for four papers, and the route of HBB administration was not the same across all studies.
CONCLUSIONS
Although, the effect of HBB was minimal when multigravidas and primigravidas women were considered together, the HBB was clinically effective in primigravida and multigravida women for shortening the first and the second stages of labor. Also, HBB could reduce the length of the third stage of labor in multigravidas.
Topics: Adult; Apgar Score; Butylscopolammonium Bromide; Cholinergic Antagonists; Female; Gravidity; Humans; Labor Stage, First; Labor, Obstetric; Muscarinic Antagonists; Parity; Pregnancy; Scopolamine; Young Adult
PubMed: 32404072
DOI: 10.1186/s12884-020-2832-3 -
Annals of the Royal College of Surgeons... Sep 2011Oesophageal soft food bolus obstruction (OSFBO) is a surgical emergency. However, no national guidelines exist regarding its management. This paper systematically... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Oesophageal soft food bolus obstruction (OSFBO) is a surgical emergency. However, no national guidelines exist regarding its management. This paper systematically reviews the literature with respect to the management of OSFBO.
METHODS
Relevant studies included were identified from the the Cochrane Library, the National Center for Biotechnology Information and the US National Library of Medicine resources. A systematic review was performed on 8 November 2010.
RESULTS
This systematic review of the management of OSFBO shows no evidence that any medical intervention is more effective than a 'watch and wait' policy in enabling spontaneous disimpaction. Furthermore, the use of hyoscine butylbromide for OSFBO probably stems from a misquoted textbook. Surgical removal of an OSFBO is effective but not without potential risk. There is some evidence to support surgical intervention within 24 hours to prevent complications deriving from the initial obstruction.
CONCLUSIONS
There is a need for large double-blind, randomised, placebo controlled trials of drugs used in the medical management of OSFBO. Until the results from such trials are available, the treatment of OSFBO will remain based on inconsistent clinical judgement.
Topics: Analgesics, Opioid; Benzodiazepines; Butylscopolammonium Bromide; Deglutition Disorders; Esophageal Stenosis; Esophagoscopy; Esophagus; Food; Foreign Bodies; Gastrointestinal Agents; Glucagon; Humans; Parasympatholytics; Watchful Waiting
PubMed: 21929913
DOI: 10.1308/003588411X588090 -
Journal of Pain and Symptom Management Feb 2007The use of symptomatic agents has greatly improved the medical treatment of advanced cancer patients with inoperable bowel obstruction. A systematic review of studies of... (Review)
Review
The use of symptomatic agents has greatly improved the medical treatment of advanced cancer patients with inoperable bowel obstruction. A systematic review of studies of the most popular drugs used in the medical management of inoperable malignant bowel obstruction was performed to assess the effectiveness of these treatments and provide some lines of evidence. Randomized trials that involved patients with a clinical diagnosis of intestinal obstruction due to advanced cancer treated with these drugs were reviewed. Five reports fulfilled inclusion criteria. Three studies compared octreotide (OC) and hyoscine butylbromide (HB), and two studies compared corticosteroids (CSs) and placebo. Globally, 52 patients received OC, 51 patients received HB, 37 patients received CSs, 15 patients received placebo, and 37 patients received both placebo and CSs. On the basis of these few data, the superiority of OC over HB in relieving gastrointestinal symptoms was evidenced in a total of 103 patients. The latter studies had samples more defined in terms of stage and inoperability, and had a shorter survival in comparison with studies of CSs (less than 61 days, most of them less than 20 days). Data on CSs are less convincing, due to the methodological weakness of existing studies. This review confirms the difficulties in conducting randomized controlled trials in this population.
Topics: Adrenal Cortex Hormones; Butylscopolammonium Bromide; Gastrointestinal Agents; Humans; Intestinal Obstruction; Muscarinic Antagonists; Neoplasms; Octreotide
PubMed: 17280927
DOI: 10.1016/j.jpainsymman.2006.06.014