Abstract

LANDAETA, Jorge L et al. Preliminary experience with carbon dioxide versus air insufflation in outpatient colonoscopies with sedation in absecence of anesthesiology monitoring. Gen [online]. 2014, vol.68, n.2, pp.53-56. ISSN 0016-3503.

Introduction: Carbon dioxide (CO₂) gas is rapidly absorbed from the intestinal lumen preventing bloating, reducing intra-and post-procedure pain, sedation requirements and duration of the procedure. Objective: To compare the effect of CO₂ and air insufflation at the time of intubation and extubation colonic doses of anesthetic and abdominal pain in patients without monitoring anesthesiologist sedated. Design: Prospective, randomized, tertiary hospital (January- May 2013). Patients and Methods: 72 patients underwent colonoscopy by an experienced endoscopist. Patients with prior colon surgery, poor preparation, therapeutic colonoscopies (resection and dissection) were excluded. 63 patients completed the study, air insufflation (33) and CO₂ (30). Videocolonoscopio Olympus 180 and Olympus UCR CO₂ pump were used. Blind intubation time extubation colon, anesthetic doses and abdominal pain (post-procedure, 30 min and 24 hours) were evaluated. Results: Of the seven patients insufflated with air (21.2%) had pain immediately post colonoscopy vs 2 (6.7%) CO₂ (p = 0.198), 30 minutes: 4 (12.1%) vs. air group 2 (6.7%) CO₂ (p = 0.759) and 24 hours: 0 (0%) air vs 2 (6.7%) CO₂ (p = 0.431). Cecal intubation group air 4.5 ± 2.0 minutes vs group CO₂ 3.9 ± 2.1 min(p = 0.876). Extubation colon group air vs group CO₂ (3.9 ± 3.3 vs 5.7 ± 4.5 min) (p = 0.081). Group air 14 patients (42.2%) had previous abdominal surgery vs 16 (53.3%) CO₂ (p = 0.540). In the CO₂ group therapeutic endoscopy was performed 20 air group vs. 11 patients (p = 0.0771). Dose Propofol air 159 ± 40 mg vs. 153 ± 63 mg CO₂ (p = 0.642). Use post-procedure pain 7 (21.21%) air vs. 4 (13.33%) CO₂ (p = 0.624). Conclusions: Our results demonstrate that seemed to be that the CO₂ does not benefi t bowel intubation and extubation, abdominal pain reduction post procedure, dose of propofol and analgesic use in monitoring sedated patients without anesthesia.

Keywords : colonoscopy; CO₂ insufflation; air insufflation; abdominal pain; cecal intubation; extubation colon.

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