2012年6月4日月曜日

Helpfulness Of Carbon Dioxide Insufflation During Colonoscopy


Miroslaw Szura, MD PhD, Rafal Solecki, MD PhD, Krzysztof Bucki, MD, Andrzej Matyja, MD PhD. MEDICINA Specialist Diagnostic & Therapeutic Centre

Introductions
Colonoscopy is currently most effective procedure used for detecting colon cancer especially in the early stages. Screening colonoscopies are performed in the symptom-free patients at risk of familial colon cancer. During colonoscopy air commonly used to insufflate the bowel may be retained after the procedure causing pain and discomfort to the patients. One of the methods used to reduce pain and discomfort is insufflation of carbon dioxide (CO2) instead of air during colonoscopy.
Aim of the study is evaluation of the use of carbon dioxide insufflation during colonoscopy.

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Material and Method
The study was conducted in 200 consecutive patients undergoing screening colonoscopies for the detection of early colon cancer. The examinations were performed with Olympus 165 videocolonoscopes by seven experienced endoscopists, each of whom performed alone about over 2000 colonoscopies. The patients were assigned to Group I and II with either air or carbon dioxide insufflation. Both study groups were matched by sex, age, duration of the procedure, and BMI. The authors compared for the duration of the procedure, pulse rates immediately after the procedure, 15 minutes after, and subjective pain evaluation on a Visual Analogue Scale.
Results
Group I consisted of 59 women and 41 men at the mean age of 58 years, mean BMI 27.8, and group II of 51 women and 49 men, mean age 57.2 years and mean BMI 27.5. Duration of the procedure was about 10 min in both groups.
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The average pulse rate measured immediately after the examination was 83/min. in group I and 84/min. in group II. Fifteen minutes after the end of the procedure the average pulse rate was 73/min in group I and 67/min. in group II. Pain measured 15 min. after the procedure was at the level 1,1 in group I and 0.8 in group II.
Conclusions
Carbon dioxide insufflation of bowel reduces pain and discomfort after colonoscopy and has no effect on duration of the procedure. The use of carbon dioxide insufflation should be evaluated during endoscopic surgical procedures.


Session: Poster
Program Number: P211
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