Pain after small bowel meal and pneumocolon: a randomized controlled trial of carbon dioxide versus air insufflation

To determine whether the use of CO2 rather than air insufflation results in less pain and/or distension in patients undergoing small bowel meal (SBM) and pneumocolon (PC).

One hundred patients for SBM and PC were randomized to receive either air or carbon dioxide (CO2) as the insufflating gas. Both the patient and radiologist were blinded to the gas being used. Patients were given a questionnaire to complete the following day. The degree and duration of abdominal pain and swelling were scored on a visual analogue scale from 0 to 100.

Seventy-nine patients replied. The mean pain score was 28.1 for patients receiving air and 20.35 for those receiving CO2 (P < 0.05). The duration of pain was 9.0 h in the air group and 6.0 h in the CO2 group (P < 0.05). The mean abdominal swelling score was 27.1 for patients receiving air and 17.1 for those receiving CO2 (P < 0.05). The duration of swelling was 8.8 h in the air groups and 7.3 h in the CO2 group (P = 0.16).

In patients presenting for SBM and PC, the severity and duration of abdominal pain and distension are significantly reduced by the use of CO2 rather than air.