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Randomized Controlled Trial
. 2017 Jul-Sep;30(3):177-181.
doi: 10.1590/0102-6720201700030004.

COLONOSCOPY: RANDOMIZED COMPARATIVE STUDY OF INSUFFLATION WITH CARBON DIOXIDE VERSUS AIR

[Article in English, Portuguese]
Luiz Gustavo DE-Quadros  1   2   3 , Roberto Luiz Kaiser-Júnior  1 , Valter Nilton Felix  4 , Lucio Villar  2 , Josemberg Marins Campos  2 , Vinicius Quintiliano Moutinho Nogueira  1 , André Teixeira  5 , Idiberto José Zotarelli-Filho  1
Affiliations
Randomized Controlled Trial

COLONOSCOPY: RANDOMIZED COMPARATIVE STUDY OF INSUFFLATION WITH CARBON DIOXIDE VERSUS AIR

[Article in English, Portuguese]
Luiz Gustavo DE-Quadros et al. Arq Bras Cir Dig. 2017 Jul-Sep.

Abstract
in English, Portuguese

Background: In Brazil, an increasing number of people are submitted to colonoscopy, either for screening or for therapeutic purposes.

Aim: To evaluate whether there are advantages of using carbon dioxide (CO2) over air for insufflation.

Methods: Two hundred and ten of 219 patients were considered eligible for this study and were randomized into two groups according to the gas insufflation used: Air Group (n=104) and CO2 Group (n=97). The study employed a double-blind design.

Results: The Air and CO2 Groups were similar in respect to bowel preparation evaluated using the Boston scale, age, gender, previous surgery, maneuvers necessary for the advancement of the device, and presence of polyps, tumors or signs of diverticulitis. However, "waking up with pain" and "pain at discharge" were more prevalent in the Air Group, albeit not statistically significant, with post-exam bloating seen only in the Air Group. The responses to a questionnaire, applied to analyze the late post-exam period, showed more comfort with the use of CO2.

Conclusions: The use of CO2 is better than air as it avoids post-examination bloating, thereby providing greater comfort to patients.

Racional:: No Brasil, estima-se crescente aumento da população submetida à colonoscopia, apesar do desconforto do exame, decorrente sobretudo da insuflação colônica.

Objetivo:: Verificar se há vantagens do uso de CO2 sobre o ar como elemento de insuflação.

Métodos:: Um total de 219 participantes foram submetidos à análise de elegibilidade e dele extraíram-se 210 eleitos, que foram randomizados em dois grupos, de acordo com o elemento utilizado: ar, n=104 e CO2, n=97. O ensaio seguiu o modelo duplo-cego.

Resultados:: Os grupos demonstraram-se similares quando cotejados preparo intestinal avaliado pela Escala de Boston, idade, gênero, operação prévia, manobras necessárias para progressão do aparelho, presença de pólipo, tumor ou sinais de diverticulite, valorizando a comparação entre eles quanto ao elemento de insuflação. Então, observou-se que “acordar com dor” e a presença de dor na ocasião da alta foram bem mais prevalentes no “Grupo Ar”, embora sem diferença estatisticamente significante, sendo a distensão pós-exame observada apenas no “Grupo Ar”. De acordo com o questionário clínico aplicado para análise do período tardio pós-exame, as respostas apontaram muito mais conforto com o uso do CO2. Os elementos de insuflação não pareceram modificar substancialmente os aspectos técnicos do exame nem provocar índices expressivos de enantema da mucosa.

Conclusão:: O uso do dióxido de carbono é superior ao ar, pois evita a distensão abdominal pós-exame conferindo maior conforto aos pacientes no período pós-exame.

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Conflict of interest statement

Conflict of interest: none.

Figures

FIGURE 1
FIGURE 1. A) Linear regression of CO2 results; B) linear regression of air resuls
See this image and copyright information in PMC

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