Revista Espanola de Enfermedades Digestivas (Jan 2008)
Tolerancia, seguridad y eficacia de la preparación para colonoscopia con fosfato de sodio: el papel de la edad Tolerability, safety and efficacy of sodium phosphate preparation for colonoscopy: The role of age
Abstract
Objetivos: comparar la tolerancia subjetiva y los efectos adversos secundarios a la preparación para colonoscopia con dos productos, polietilenglicol (PEG) y fosfato de sodio (NaP), en pacientes adultos y en aquellos de 65 años o más. Material y métodos: estudio retrospectivo apareado, tras escoger aleatoriamente a 140 pacientes de todos los que se sometieron a colonoscopia entre marzo de 2004 y mayo de 2005. Se investigó la presencia de los siguientes efectos adversos durante la preparación para la colonoscopia: fiebre, rectorragia, dolor abdominal, dolor perianal, náuseas, vómitos, sed, somnolencia, agitación, temblor y convulsiones. Se consideró mala tolerancia objetiva si el paciente presentó uno cualquiera de estos efectos. Asimismo, se recogió la tolerancia subjetiva al proceso de limpieza. Resultados: se incluyeron 70 pacientes preparados con PEG y 70 pacientes con NaP (69 mujeres y 71 hombres, con edad media de 60,6 ± 14,8 años). No se demostró relación entre la tolerancia subjetiva o la presencia de efectos adversos y la limpieza con uno de los dos productos, ni en la población general ni en los pacientes de 65 años o más (p = 0,09 y p = 0,45 en los ancianos, respectivamente). A pesar de ello, los pacientes preparados con NaP presentaron más náuseas que los tratados con PEG (p Objectives: to compare subjective tolerance and secondary adverse events to bowel cleansing prior to colonoscopy with polyethylene glycol (PEG) and sodium phosphate (NaP) in adult patients and in those 65 or more years old. Material and methods: retrospective matched study, choosing 140 patients among all of those who underwent colonoscopy from March 2004 to May 2005. We investigated the presence of the next adverse events during bowel preparation: Fever, low digestive bleeding, abdominal pain, perianal pain, nausea, vomiting, thirst, somnolence, agitation, tremor and convulsions. We considered bad objective tolerance if the patient presented any one of these events. We also asked patients about subjective tolerance to preparation. Results: seventy patients prepared with PEG and seventy with NaP were included (69 women and 71 men, mean age 60,6 ± 14,8 years). There was no relationship between subjective tolerance or the presence of adverse events and bowel cleansing with any of the products in general population or in elderly patients (p = 0,09 and p = 0,45 in the elderly). However, patients prepared with NaP showed more nausea than those who employed PEG (p < 0,009), overall women of 65 or more years old. There were no severe adverse events in patients prepared with NaP. Elderly showed better tolerance than younger patients, and women worst tolerance than men, irrespective of the lavage preparation employed. Patients prepared with PEG unfinished bowel cleansing more frequently than those with NaP. Cleanliness achieved with NaP was significantly better than that obtained with PEG. Conclusions: bowel cleansing prior to colonoscopy with NaP is as well tolerated, safe and effective as with PEG, even in elderly healthy patients, although it causes more nausea. Cleanliness with NaP is better than that achieved with PEG.
