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

BACKGROUND

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

OBJECTIVE

We evaluated the effect of CO 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 CO insufflation (CO group,  = 66) or air insufflation (air group,  = 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 CO group vs. 17.5 in the air group at 1 h PP (  =  0.047). Also, the proportion of patients without pain was significantly higher in the CO group at 1 h PP ( = 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 CO insufflation for endoscopic resection of LCPs in terms of decreasing PP abdominal pain (KCT0001636).