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Carbon dioxide insufflation during colonoscopy in deeply sedated patients

World Journal of Gastroenterology 2012年第25期18卷 3250-3253页

作者： Rajvinder Singh Eu Nice Neo Nazree Nordeen Ganesananthan Shanmuganathan Angelie Ashby sharon drummond Garry Nind Elizabeth Murphy Andrew Luck Graeme Tucker William Tam Division of Gastroenterology Department of MedicineLyell McEwin HospitalSouth Australia 5070Australia Department of Medicine University of AdelaideSouth Australia 5070Australia Colorectal Unit Department of SurgeryLyell McEwin HospitalSouth Australia 5070Australia Pantai Hospital Kuala Lumpur 50000Malaysia Health Statistics Unit South Australia Health CenterSouth Australia 5000Australia

AIM:To compare the impact of carbon dioxide(CO2) and air insufflation on patient tolerance/safety in deeply sedated patients undergoing ***:Patients referred for colonoscopy were randomized to receive either CO2 or air insufflation during the *** the colonoscopist and patient were blinded to the type of gas *** the procedure,insertion and withdrawal times,caecal intubationrates,total sedation given and capnography readings were *** level of sedation and magnitude of patient discomfort during the procedure was assessed by a nurse using a visual analogue scale(VAS)(0-3).Patients then graded their level of discomfort and abdominal bloating using a similar *** during and after the procedure were ***:A total of 142 patients were randomized with 72 in the air arm and 70 in the CO2 *** age between the two study groups were *** time to the caecum was quicker in the CO2 group at 7.3 min vs 9.9 min with air(P = 0.0083).The average withdrawal times were not significantly different between the two *** intubation rates were 94.4% and 100% in the air and CO2 groups respectively(P = 0.012).The level of discomfort assessed by the nurse was 0.69(air) and 0.39(CO2)(P = 0.0155) and by the patient 0.82(air) and 0.46(CO2)(P = 0.0228).The level of abdominal bloating was 0.97(air) and 0.36(CO2)(P = 0.001).Capnography readings trended to be higher in the CO2 group at the commencement,caecal intubation,and conclusion of the procedure,even though this was not significantly different when compared to readings obtained during air *** were no complications in both ***:CO2 insufflation during colonoscopy is more efficacious than air,allowing quicker and better cecal intubation *** discomfort and bloating were significantly less with CO2 insufflation.

关键词： Colonoscopy Carbon dioxide Air Insuffla-tions, Patient tolerance Safety, Efficacy

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