![]() ![]() I just reviewed the evidence on Buscopan for an upcoming episode of EM Cases, and it doesn’t seem to work very well. I had never heard of Donnatal, but I know a lot of people use Buscopan in Canada, which is a similar “antispasmodic” anticholinergic agent. It is possible that other combinations may be more effective than those tried here. One big issue with this study is that there really is no standard “GI cocktail”. Also, the volume provided in each group was different, so the assigned group would be pretty obvious. (Goodson 1986 Graham 1983 Lanza 1986 Malmud 1978 Weberg 1989) Although all patients were blinded, it is unlikely blinding was successful considering the obvious clinical effects of lidocaine. They did not include a placebo group, but that seems reasonable considering the numerous cited studies demonstrating benefit from antacids in the management of dyspepsia. This is a well done study and it is important considering how often the “pink lady” or “GI cocktail” is ordered in emergency departments. There was no statistically significant difference between the groups. Group 1: 25mm +/- 27mm (standard deviation).They enrolled 120 patients over a 6 month period, and 113 completed the protocol. A 13 mm (out of 100) difference was considered clinically significant. ![]() The primary outcome was relief of pain (as measured by the difference in millimeters between the pretreatment and posttreatment visual analog scales) at 30 minutes. Group 3: 30 mL of Mylanta plus 10mL of Donnatal plus 10 mL of 2% viscous lidocaine Outcome Group 2: 30 mL of Mylanta plus 10mL of Donnatal (a combination of phenobarbital, hyoscyamine sulfate, atropine sulfate, and scopolamine hydrobromide, meant to act as an antispasmodic and anticholinergic agent) Group 1: 30 mL of Mylanta (a combination of magnesium hydroxide, aluminium hydroxide, and simethicone)
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