EvaluaciĆ³n comparativa de efectividad y tolerabilidad con polietilenglicol y picosulfato de sodio-citrato de magnesio como agentes de preparaciĆ³n intestinal para colonoscopia
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2018
Profesor/a GuĆa
Facultad/escuela
Idioma
es
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Sociedad de Cirujanos de Chile
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Licencia CC
Licencia CC
Resumen
La efectividad de la colonoscopia depende de mĆŗltiples factores, destacando la calidad
de preparaciĆ³n intestinal y la tolerabilidad que tenga el paciente a la preparaciĆ³n administrada. Objetivo: Comparar dos agentes de preparaciĆ³n intestinal, el polietilenglicol (PEG) y el picosulfato de sodiocitrato de magnesio (PSCM) en tĆ©rminos de efectividad y tolerabilidad de la preparaciĆ³n. Pacientes y
MĆ©todo: Ensayo clĆnico aleatorizado en pacientes ambulatorios sometidos a colonoscopia en ClĆnica
INDISA. Evaluando efectividad y tolerabilidad con el Boston Bowel Preparation Score (BBPS) y cuestionario de Lawrence [compuesto por escala Likert, dos preguntas cualitativas y escala visual anƔloga
(EVA)], respectivamente. Resultados: 189 pacientes, de los cuales 123 se aleatorizaron a PEG y 66 a
PSCM. El BBPS en los pacientes que utilizaron PEG, la media fue 7,51 (DS 1,66) y con PSCM fue 7,12
(DS 1,71) (p = 0,111). Al analizar la tolerabilidad con escala Likert, la media con PEG fue 0,94 (DS 0,68)
y con PSCM fue 0,63 (DS 0,61) (p = 0,0004). La EVA con PEG tuvo una media de 7,68 (DS 2,4) y con
PSCM de 9,04 (DS 1,59) (p < 0,0001). Al preguntar ausentismo laboral, no hubo diferencias significativas en ambos grupos y al preguntar si ocuparĆa la misma preparaciĆ³n en una futura colonoscopia, hubo
significancia estadĆstica a favor del PSCM (p = 0,026). ConclusiĆ³n: No encontramos diferencias en la
efectividad de preparaciĆ³n intestinal al comparar PEG y PSCM, sin embargo, el PSCM es mejor tolerado.
The effectiveness of colonoscopy depends on multiple factors, being two of the most important ones an adequate bowel preparation and the patientās tolerability to the preparation. Objectives: Compare effectiveness and tolerability of two bowel preparation agents, polyethylene glycol (PEG) and sodium picosulfate/magnesium citrate (SPMC). Patients and Methods: Randomized clinical trial on outpatients that went into colonoscopy in INDISA Clinic. We evaluated effectiveness and tolerability with Boston Bowel Preparation Score (BBPS) and Lawrence questionnaire [composed by Likert scale, two qualitative questions and Visual Analogue Scale (VAS) for pain], respectively. Results: 189 patients, 123 were randomized to PEG and 66 to SPMC. BBPS average in patients in the PEG branch was 7.51 (SD 1.66) and for SPMC 7.12 (SD 1.71) (p = 0.111). Likert scale for evaluating tolerability average for PEG was 0.94 (SD 0.68) and for SPMC 0.63 (SD 0.61) (p = 0.0004). VAS scale for PEG had an average of 7.68 (SD 2.4) and for PSCM 9.04 (SD 1.59) (p < 0.0001). When we asked for workplace absenteeism, there were no significant differences between both groups and when we asked about using the same intestinal preparation in a future colonoscopy there was statistical significance in favor to SPMC (p = 0.026). Conclusions: No differences were noted on effectiveness between the PEG and SPMC bowel preparations. Nevertheless, SPMC appeared to be better tolerated by patients. Ā© 2018, Sociedad de Cirujanos de Chile. All rights reserved.
The effectiveness of colonoscopy depends on multiple factors, being two of the most important ones an adequate bowel preparation and the patientās tolerability to the preparation. Objectives: Compare effectiveness and tolerability of two bowel preparation agents, polyethylene glycol (PEG) and sodium picosulfate/magnesium citrate (SPMC). Patients and Methods: Randomized clinical trial on outpatients that went into colonoscopy in INDISA Clinic. We evaluated effectiveness and tolerability with Boston Bowel Preparation Score (BBPS) and Lawrence questionnaire [composed by Likert scale, two qualitative questions and Visual Analogue Scale (VAS) for pain], respectively. Results: 189 patients, 123 were randomized to PEG and 66 to SPMC. BBPS average in patients in the PEG branch was 7.51 (SD 1.66) and for SPMC 7.12 (SD 1.71) (p = 0.111). Likert scale for evaluating tolerability average for PEG was 0.94 (SD 0.68) and for SPMC 0.63 (SD 0.61) (p = 0.0004). VAS scale for PEG had an average of 7.68 (SD 2.4) and for PSCM 9.04 (SD 1.59) (p < 0.0001). When we asked for workplace absenteeism, there were no significant differences between both groups and when we asked about using the same intestinal preparation in a future colonoscopy there was statistical significance in favor to SPMC (p = 0.026). Conclusions: No differences were noted on effectiveness between the PEG and SPMC bowel preparations. Nevertheless, SPMC appeared to be better tolerated by patients. Ā© 2018, Sociedad de Cirujanos de Chile. All rights reserved.
Notas
IndexaciĆ³n Scopus
Palabras clave
Soluciones para preparaciĆ³n intestinal, Colonoscopia, Polietilenglicoles, Picosulfato de sodio, Agente catĆ”rtico, Citrato de magnesio
CitaciĆ³n
Revista Chilena de Cirugia Volume 70, Issue 3, Pages 224 - 232 2018
DOI
10.4067/s0718-40262018000300224