Difficult colonoscopy: air, carbon dioxide, or water insufflation?

Intestinal Research

Meghraj Ingle¹  Alisha Chaubal¹  Aniruddha Phadke¹  Vikas Pandey¹  Ruchir Patel¹  Prabha Sawant¹  Prateik Poddar¹ 

[1] Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, .India;

关键词: Colonoscopy;    Insufflation;    Carbon dioxide insufflation;    Water immersion;   

DOI  :  10.5217/ir.2018.16.2.299

来源: DOAJ

【 摘 要 】

Background/AimsThis study aimed to compare tolerance to air, carbon dioxide, or water insufflation in patients with anticipated difficult colonoscopy (young, thin, obese individuals, and patients with prior abdominal surgery or irradiation).MethodsPatients with body mass index (BMI) less than 18 kg/m2 or more than 30 kg/m2, or who had undergone previous abdominal or pelvic surgeries were randomized to air, carbon dioxide, or water insufflation during colonoscopy. The primary endpoint was cecal intubation with mild pain (less than 5 on visual analogue scale [VAS]), without use of sedation.ResultsThe primary end point was achieved in 32.7%, 43.8%, and 84.9% of cases with air, carbon dioxide and water insufflation (P<0.001). The mean pain scores were 5.17, 4.72, and 3.93 on the VAS for air, carbon dioxide, and water insufflation (P<0.001). The cecal intubation rate or procedure time did not differ significantly between the 3 groups.ConclusionsWater insufflation was superior to air or carbon dioxide for pain tolerance. This was seen in the subgroups with BMI <18 kg/m2 and the post-surgical group, but not in the group with BMI >30 kg/m2.

【 授权许可】

Unknown