Carbon dioxide insufflation in routine colonoscopy is safe and more comfortable: Results of a randomized controlled double-blinded trial

Abstract

Many patients experience pain and discomfort after colonoscopy. Carbon dioxide (CO2) can reduce periprocedural pain although air insufflation remained the standard procedure. The objective of this double-blinded, randomized controlled trial was to evaluate whether CO 2 insufflation does decrease pain and bloating during and after colonoscopy compared to room air. Methods. 219 consecutive patients undergoing colonoscopy were randomized to either CO2 or air insufflation. Propofol was used in all patients for sedation. Transcutaneous CO2 was continuously measured with a capnograph as a safety parameter. Pain, bloating, and overall satisfaction were assessed at regular intervals before and after the procedure. Results (data are mean ±SD). 110 patients were randomized to CO2 and 109 to room air. The baseline characteristics were similar in both groups. The mean propofol dose was not different between the treatments, as were the time to reach the ileum and the withdrawal time. pCO2 at the end of the procedure was 35.2±4.3 mmHg (CO 2 group) versus 35.6±6.0 mmHg in the room air group (P>.05). No relevant complication occurred in either group. There was significantly less bloating for the CO2 group during the postprocedural recovery period (P