Effect of carbon dioxide versus room air insufflation on post-colonoscopic pain: A prospective, randomized, controlled study.


Journal

The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology
ISSN: 2148-5607
Titre abrégé: Turk J Gastroenterol
Pays: Turkey
ID NLM: 9515841

Informations de publication

Date de publication:
10 2020
Historique:
entrez: 10 11 2020
pubmed: 11 11 2020
medline: 15 10 2021
Statut: ppublish

Résumé

Room air (RA) and carbon dioxide (CO2) are widely used to insufflate the colon to examine the mucosa in colonoscopy. Pain, discomfort, and bloating can be seen during and after colonoscopy secondary to bowel distention. This study aimed to investigate the effect of CO2 on post-procedure pain sensation (PPPS) in comparison with RA. Patients were randomly assigned to the RA and CO2 insufflation groups in a 1:1 ratio. The visual analog scale (VAS) was used to measure the pain before and after the colonoscopy. VAS score of 0 was accepted as the absence of pain and above 0 was accepted as the presence of pain. The primary outcome was to investigate the effect of CO2 insufflation on PPPS. Secondary outcomes were to investigate the other contributing factors affecting PPPS and the effect of CO2 on PPPS in patients with inflammatory bowel disease (IBD). A total of 204 patients were enrolled in the study. No significant difference in PPPS was seen between the 2 groups at any point in time after the colonoscopy. Furthermore, there was no significant difference in pain sensation between the CO2 and RA groups in patients with IBD. When we investigated the other contributing factors to pain sensation, body-mass index (BMI) was found to be significant at 30 minutes and BMI and colonoscopy time were found to be significant at 6 hours afterwards. We found no favorable effect of CO2 insufflation on PPPS in colonoscopy, including in patients with IBD.

Sections du résumé

BACKGROUND/AIMS
Room air (RA) and carbon dioxide (CO2) are widely used to insufflate the colon to examine the mucosa in colonoscopy. Pain, discomfort, and bloating can be seen during and after colonoscopy secondary to bowel distention. This study aimed to investigate the effect of CO2 on post-procedure pain sensation (PPPS) in comparison with RA.
MATERIALS AND METHODS
Patients were randomly assigned to the RA and CO2 insufflation groups in a 1:1 ratio. The visual analog scale (VAS) was used to measure the pain before and after the colonoscopy. VAS score of 0 was accepted as the absence of pain and above 0 was accepted as the presence of pain. The primary outcome was to investigate the effect of CO2 insufflation on PPPS. Secondary outcomes were to investigate the other contributing factors affecting PPPS and the effect of CO2 on PPPS in patients with inflammatory bowel disease (IBD).
RESULTS
A total of 204 patients were enrolled in the study. No significant difference in PPPS was seen between the 2 groups at any point in time after the colonoscopy. Furthermore, there was no significant difference in pain sensation between the CO2 and RA groups in patients with IBD. When we investigated the other contributing factors to pain sensation, body-mass index (BMI) was found to be significant at 30 minutes and BMI and colonoscopy time were found to be significant at 6 hours afterwards.
CONCLUSION
We found no favorable effect of CO2 insufflation on PPPS in colonoscopy, including in patients with IBD.

Identifiants

pubmed: 33169704
doi: 10.5152/tjg.2020.20596
pmc: PMC7659903
doi:

Substances chimiques

Carbon Dioxide 142M471B3J

Types de publication

Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

676-680

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Auteurs

Feyza Gündüz (F)

Department of Gastroenterology, Marmara University School of Medicine, İstanbul, Turkey;Marmara University, Institute of Gastroenterology, İstanbul, Turkey.

Haluk Tarık Kani (HT)

Department of Gastroenterology, Marmara University School of Medicine, İstanbul, Turkey.

Shannon Chang (S)

Division of Gastroenterology, Inflammatory Bowel Disease Center, New York University Langone Health, New York, New York.

Esra Akdeniz (E)

Department of Medical Education, Marmara University, School of Medicine, İstanbul, Turkey.

Fatih Eren (F)

Marmara University Institute of Gastroenterology, İstanbul, Turkey; Department of Medical Biology, Marmara University School of Medicine, İstanbul, Turkey.

Yusuf Yılmaz (Y)

Department of Gastroenterology, Marmara University School of Medicine, İstanbul, Turkey;Marmara University, Institute of Gastroenterology, İstanbul, Turkey.

Yeşim Özen Alahdab (YÖ)

Department of Gastroenterology, Marmara University School of Medicine, İstanbul, Turkey;Marmara University, Institute of Gastroenterology, İstanbul, Turkey.

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Classifications MeSH