title: Pain following colonoscopy: elimination with carbon dioxide.
abstract: Fifty-six patients have been examined in a prospective randomized study on the effects of air and carbon dioxide on post-procedural discomfort following colonoscopy. A significant reduction in post-procedural pain was observed at 6 hours (p = < 0.0005) and was still present the next day (p = 0.01). This was associated with a difference in the grading of flatus at 6 and 24 hours (p = < 0.0001 and < 0.05, respectively). An abdominal radiograph 1 hour after the procedure showed minimal gas in the CO2 patients, while the patients who had air showed distention of large and small bowel (p = < 0.0001 and < 0.01, respectively). Seventeen of 29 patients who had air suffered post-procedural pain, compared with 2 of 27 of the CO2 patients. Fifty-seven percent of the patients who were given air had colonic diameters over 6 cm on a 1-hour post-colonoscopy radiograph and 18% over 10-cm diameter. Provision by equipment manufacturers of simple and safe devices for routine delivery of CO2 for lower gastrointestinal endoscopy is long overdue.
authors.affiliation: Department of Radiology, McMaster University, Hamilton, Ontario, Canada.
authors.forename: G W
authors.initials: GW
authors.lastname: Stevenson
authors.forename: J A
authors.initials: JA
authors.lastname: Wilson
authors.forename: J
authors.initials: J
authors.lastname: Wilkinson
authors.forename: G
authors.initials: G
authors.lastname: Norman
authors.forename: R L
authors.initials: RL
authors.lastname: Goodacre
mesh_terms: D002245:Carbon Dioxide; D003106:Colon / Q000000981:diagnostic imaging; D003113:Colonoscopy / Q000009:adverse effects* / Q000379:methods; D005414:Flatulence; D006801:Humans; D007327:Insufflation; D007421:Intestine, Small / Q000000981:diagnostic imaging; D010146:Pain / Q000517:prevention & control*; D011446:Prospective Studies; D011859:Radiography
chemical_list: D002245:Carbon Dioxide