Comparison between insufflation with air or carbon dioxide during the colonoscopy in sedated patients with propofol

Díez-Redondo, P.; Gil-Simón, P.; Alcaide-Suárez, N.; Atienza-Sánchez, R.; Barrio-Andrés, J.; Serna-Higuera,; Pérez-Miranda, M.

Revista Española de Enfermedades Digestivas 104(8): 411-417


DOI: 10.4321/s1130-01082012000800004
Accession: 068501488

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compare the intensity of pain experienced after colonoscopy with air or with CO₂ and evaluate the safety of CO₂ in colonoscopies performed with moderate/deep sedation. individuals undergoing ambulatory colonoscopy without exclusion criteria (severe respiratory disease, morbid obesity) were randomized in air or CO₂ group. We recorded different variables prior to, during and upon completion of the colonoscopy, performing monitoring using pulse oximetry and capnography. Each patient rated, using a visual numeric scale, the intensity of post-colonoscopy pain at different moments. 141 individuals in the air group (sex M/F 63/78, age 24-83) and the CO₂ group (sex M/F 59/70, age 24-82). No significant differences existed in the recorded variables in both groups except for the greater number of explorations performed by an endoscopist in training (TE) in the air group compared to those by a more experienced endoscopist (SE). CO2 in expired air, episodes of oxygen desaturation and of apnoea and dose of propofol, of midazolam were similar in both groups. No episodes of hypercapnea or any complication requiring cardiopulmonary resuscitation measures were recorded. The pain in the air group was significantly higher at 15 minutes and at 1, 3 and 6 hours after the endoscopy, equalising at 24 hours. After multivariant adjustment for type of doctor (TE vs. SE) the differences observed in pain intensity for each group were maintained. a) the use of CO₂ in colonoscopy causes significantly less pain in the first 6 hours after the procedure; b) its use in patients with moderate/deep sedation is safe; and c) performance of the endoscopic technique is not modified, nor are times reduced.