BACKGROUND Although several trials have shown that the addition of antifoaming agents to polyethylene glycol (PEG) can improve bowel preparation, whether PEG plus antifoaming agents have a beneficial role in the detection of benign tumors during colonoscopy has yet to be confirmed. Our aim was to clarify whether adding simethicone to PEG solution could improve the detection of benign colorectal tumors. AIM To clarify whether adding simethicone to PEG solution could improve the detection of benign colorectal tumors. METHODS The PubMed, EMBASE, and Cochrane Library databases were searched for articles published prior to September 2019. The outcomes included the detection rates of colorectal adenomas and polyps. RESULT Twenty studies were eligible. Although there was no difference in the colorectal adenoma detection rate (ADR), a significant effect of simethicone for diminutive adenomas (< 10 mm) was revealed in the group taking simethicone. We also found that simethicone could significantly improve the ADR in the proximal colon but did not affect the colorectal polyp detection rate. Furthermore, the subgroup analyses revealed a beneficial effect of simethicone on the ADR among Asians ( P = 0.005) and those with an ADR < 25% ( P = 0.003). Moreover, it was a significant finding that the low dose simethicone was as effective as the high dose one with respect to the detection of benign colorectal tumors. CONCLUSION In summary, the addition of simethicone to PEG might improve the detection of diminutive adenomas in the right colon by colonoscopy in Asia. Low-dose simethicone was recommended for the detection of benign colorectal tumors. However, large clinical trials are necessary to validate our results and determine the ideal dose of simethicone.
The purpose was to determine the effective dose of remimazolam (RMZ) combined with different doses butorphanol inhibiting response to cervical dilation during artificial abortion. This is a prospective, randomized, and double-blind study. Sixty-one female patients were randomly assigned to Group B10 (31 patients) and Group B15 (30 patients). All patients were given RMZ 5 min after an intravenous (IV) administration of butorphanol 10 μg/kg (Group B10) and 15 μg/kg (Group B15). According to the pre-experiment, the first dose of RMZ in the first patient was 0.35 mg/kg, and the adjacent geometric dose ratio was 0.9. The centered isotonic regression was performed to determine the ED50 and ED90 of RMZ and their corresponding 90% confidence interval (CI). The total RMZ dose administered, recovery time, and anesthesia-related adverse events were all recorded. The recovery time in Group B10 was significantly shorter than in Group B15. The incidence of post-operative nausea and vomiting (PONV) in the B10 and B15 groups was 3.2% and 16.7%, respectively. Therefore, to enhance the sedative effect of RMZ, the recommended dose of butorphanol is 10 μg/kg, and the ED50 and ED90 of the RMZ during painless artificial abortion were 0.263 and 0.331 mg/kg, respectively.
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