Carbon dioxide vs. air insufflation in ileo-colonoscopy and in gastroscopy plus ileo-colonoscopy: a comparative study.
BACKGROUND
insufflation with carbon dioxide (CO2) during endoscopies compared to air is associated with a decrease in abdominal discomfort after the examination, because CO2 is readily absorbed through the small intestine and eliminated by the lungs.


OBJECTIVE
the objective of this randomized clinical trial was to assess the effect of CO2 insufflation on pain and abdominal distension after an ileo-colonoscopy (I) and after an ileo-colonoscopy plus gastroscopy (I+G).


METHODS
we included a total of 309 patients in the study and all endoscopies were performed under sedation with propofol. Two hundred fourteen patients underwent an I (132 with CO2 / 82 with air) and 95 underwent an I+G (53 with CO2 / 42 with air). Abdominal pain was studied at 10, 30 and 120 minutes of exploration and abdominal perimeter difference before and after the procedure.


RESULTS
both in group I and in group I+G, the use of CO2 translated into an average of abdominal pain significantly lower (p < 0.05). Similarly, a smaller increase in waist circumference was found among group I and group I+G, in patients where CO2 was used (p < 0.05).


CONCLUSIONS
the insufflation of CO2 instead of air during the performance of endoscopy significantly reduces the discomfort and abdominal pain after an ileo-colonoscopy and after a gastroscopy + ileo-colonoscopy.
Department of Gastroenterology, Clínica Universidad de Navarra. Navarra, Spain.mfdezcalderon@gmail.com
María
M
Fernández-Calderón
Miguel Ángel
MÁ
Muñoz-Navas
Juan
J
Carrascosa-Gil
María Teresa
MT
Betés-Ibáñez
Susana
S
de-la-Riva
César
C
Prieto-de-Frías
María Teresa
MT
Herráiz-Bayod
Cristina
C
Carretero-Ribón
D015746:Abdominal Pain / Q000209:etiology / Q000517:prevention & control*; D000368:Aged; D000388:Air; D002245:Carbon Dioxide; D003113:Colonoscopy / Q000009:adverse effects / Q000379:methods*; D004108:Dilatation, Pathologic / Q000209:etiology / Q000517:prevention & control; D004311:Double-Blind Method; D005260:Female; D005773:Gastroscopy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007327:Insufflation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged
D002245:Carbon Dioxide