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. 2018 Aug;6(7):1089-1098.
doi: 10.1177/2050640618776740. Epub 2018 May 4.

Carbon dioxide insufflation during endoscopic resection of large colorectal polyps can reduce post-procedure abdominal pain: A prospective, double-blind, randomized controlled trial

Su Young Kim  1   2 , Jun-Won Chung  2 , Jung Ho Kim  2 , Yoon Jae Kim  2 , Kyoung Oh Kim  2 , Kwang An Kwon  2 , Dong Kyun Park  2
Affiliations

Carbon dioxide insufflation during endoscopic resection of large colorectal polyps can reduce post-procedure abdominal pain: A prospective, double-blind, randomized controlled trial

Su Young Kim et al. United European Gastroenterol J. 2018 Aug.

Abstract

Background: Studies of the use of CO2 insufflation during endoscopic resection of large colorectal polyps (LCPs) are lacking.

Objective: We evaluated the effect of CO2 insufflation on pain after endoscopic resection of LCPs.

Methods: In a prospective randomized controlled trial (RCT), 132 patients were randomly assigned to groups who underwent endoscopic resection with CO2 insufflation (CO2 group, n = 66) or air insufflation (air group, n = 66). The primary outcome was abdominal pain post-procedure (PP). The secondary outcomes were abdominal distension, rates of technical success, amounts of sedatives prescribed, use of analgesics, and adverse events.

Results: Baseline patient characteristics were similar between the groups. The mean abdominal pain score was 12.3 in the CO2 group vs. 17.5 in the air group at 1 h PP (p = 0.047). Also, the proportion of patients without pain was significantly higher in the CO2 group at 1 h PP (p = 0.008). The pain score differed more in the endoscopic submucosal dissection group and long-time group. The secondary outcomes were not significantly different between the two groups.

Conclusions: The results of this RCT demonstrate the superiority of CO2 insufflation for endoscopic resection of LCPs in terms of decreasing PP abdominal pain (KCT0001636).

Keywords: Carbon dioxide; colonoscopy; colorectal polyp; endoscopic mucosal resection; endoscopic submucosal dissection.

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Figures

Figure 1.
Figure 1.
Patients’ flow-chart. COPD: chronic obstructive pulmonary disease; CO2: carbon dioxide.
Figure 2.
Figure 2.
Visual analog scale scores for abdominal pain of the CO2 and air groups after endoscopic resection of large colorectal polyps. Patients in the CO2 group had significantly lower pain scores 1 hour after the procedure.
Figure 3.
Figure 3.
Proportion of patients free of pain. The proportion of patients free of pain was higher in the CO2 group than in the air group at all time points. The difference was significant 1 hour after the procedure.
See this image and copyright information in PMC

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