title: Insufflation using carbon dioxide versus room air during colonoscopy: comparison of patient comfort, recovery time, and nursing resources.
abstract: The standard of practice for colonoscopy is room air insufflation. Recent research demonstrates safety and significant decrease in postcolonoscopy discomfort from distention when carbon dioxide (CO2) is used during insufflation. Reducing abdominal pain after colonoscopy may lead to increased acceptance of colonoscopy screening for colorectal cancer. This study aims to compare patient comfort intra- and postprocedure, length of recovery, and nursing time in patients undergoing colonoscopy using room air vs. CO2 insufflation. This study uses an experimental design with patients randomly assigned to either room air or CO2 during colonoscopy. Physician endoscopists, postprocedure nurses, and patients were blinded to assignment. Prior bowel surgery, inflammatory bowel disease, or inability to consent excluded participants. Outcome measures included discomfort assessment, nursing tasks, and recovery time.Of 191 participants, 177 were men and 14 were women; 94 received room air; 97 received CO2. Patients insufflated with room air reported higher levels of some measures of discomfort: (a) during colonoscopy (p = .02), (b) on admission to recovery (p = .001), and (c) on discharge from recovery (p = .001). Patients receiving room air required more nursing tasks in recovery (p = .001) and more total nursing time (p = .001).Compared with room air, CO2 insufflation increases patient comfort and decreases nursing tasks and time.
authors.affiliation: Isabelle Lynch, MBA, BSN, RN, is Nurse Clinician, Department of Gastroenterology, Veterans Affairs Medical Center, San Francisco, California. Ann Hayes, BSN, RN, CGRN, is Charge Nurse, Gastroenterology Intervention and Diagnostic Center, Veterans Affairs Medical Center, San Francisco, California. Martha D. Buffum, PhD, RN, PMHCNS-BC, is Nurse Researcher (WOC), Veterans Affairs Medical Center, San Francisco, California; and Clinical Professor, School of Nursing, University of California, San Francisco. Erin E. Conners, MPH, is Doctoral Student, Veterans Affairs Medical Center, San Francisco, California.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Lynch
authors.forename: Ann
authors.initials: A
authors.lastname: Hayes
authors.forename: Martha D
authors.initials: MD
authors.lastname: Buffum
authors.forename: Erin E
authors.initials: EE
authors.lastname: Conners
mesh_terms: D000388:Air; D002245:Carbon Dioxide; D003113:Colonoscopy / Q000379:methods* / Q000451:nursing; D005260:Female; D006801:Humans; D008297:Male; D000070659:Patient Comfort
chemical_list: D002245:Carbon Dioxide