Department of Gastroenterology, Akita Red Cross Hospital, 222-1 Kami-kitade-saruta, Akita, Akita, 010-1495, Japan.
J Gastroenterol. 2010 Dec;45(12):1235-40. doi: 10.1007/s00535-010-0286-5. Epub 2010 Jul 16.
Insufflation with carbon dioxide (CO(2)) in colonoscopy has not been widely adopted and, consequently, limited data are available on insufflated gas volume and blood pCO(2). The aim of this study was to compare CO(2) and air as an insufflation agent in patients undergoing colonoscopy without sedation in terms of insufflated gas volume, pCO(2), pain and examination time.
This was a randomized, double-blind, control trial. Consecutive patients presenting for colonoscopy, excluding those with lung or malignant disease, were randomized into two groups: insufflation with air or with CO(2), respectively. Insufflated gas volume, pain, pCO(2) and examination time were assessed.
The study cohort comprised 120 patients (66 randomized to CO(2) group). No significant difference in insufflated gas volumes was found between the CO(2) and air groups. The mean pCO(2) measured before, during (the peak value) and 30 min after colonoscopy were 40, 43 and 40 mmHg, respectively, in both groups. The pain scores in the air group were significantly greater than those in the CO(2) group until 3 h after the examination. There was a significant faster cecal intubation time and a trend toward shorter examination time in the CO(2) group.
The CO(2) gas volume used in our study (14.0 L) was much greater than that reported by others (8.3 L), but the pCO(2) values were still within the normal reference range, indicating the safety of CO(2) insufflation over a greater range of CO(2) gas volume. Among our patients, CO(2) insufflation was associated with relatively less pain and a shorter examination time. Based on our results, we recommend that CO(2) become the standard gas for insufflation in patients undergoing colonoscopy without sedation.
二氧化碳（CO₂）在结肠镜检查中的充气应用尚未广泛采用，因此，关于充气量和血 pCO₂的数据有限。本研究旨在比较 CO₂和空气作为非镇静结肠镜检查患者的充气剂，比较充气量、pCO₂、疼痛和检查时间。
这是一项随机、双盲、对照试验。连续就诊的结肠镜检查患者，排除有肺部或恶性疾病的患者，随机分为两组：分别用空气或 CO₂充气。评估充气量、疼痛、pCO₂和检查时间。
研究队列包括 120 例患者（66 例随机分配至 CO₂组）。CO₂和空气组之间的充气量无显著差异。两组患者在结肠镜检查前、检查期间（峰值）和检查后 30 分钟时的平均 pCO₂分别为 40、43 和 40mmHg。空气组的疼痛评分在检查后 3 小时内显著高于 CO₂组。CO₂组的盲肠插管时间明显更快，检查时间也有缩短的趋势。
我们研究中使用的 CO₂气体量（14.0 L）远大于其他研究报告的（8.3 L），但 pCO₂值仍在正常参考范围内，表明在更大的 CO₂气体量范围内使用 CO₂充气是安全的。在我们的患者中，CO₂充气与相对较少的疼痛和较短的检查时间相关。基于我们的结果，我们建议 CO₂成为非镇静结肠镜检查患者的标准充气气体。
