Towards painless colonoscopy: a randomized controlled trial on carbon dioxide-insufflating colonoscopy

Area of Science:

• Gastroenterology
• Medical Devices
• Clinical Trials

Background:

• Limited data exist on pain reduction with carbon dioxide (CO2) insufflation during colonoscopy.
• Assessing CO2 insufflation's effect on pain is crucial for patient comfort and procedural acceptance.

Purpose of the Study:

• To evaluate the impact of CO2 insufflation versus air insufflation on pain during and after colonoscopy.
• To compare patient satisfaction and acceptance between CO2 and air insufflation groups.

Main Methods:

• A randomized controlled trial comparing CO2 insufflation (CO2i) and air insufflation (AIRi).
• Pain assessment using a visual analogue scale (VAS) during and post-procedure.
• Evaluation of caecal intubation rate, time to caecum, complications, and patient satisfaction.

Main Results:

• CO2 insufflation group reported significantly lower pain scores during (P < 0.01) and 30 minutes after (P = 0.02) colonoscopy.
• A higher percentage of patients in the CO2i group experienced a painless procedure (VAS 0) both during (45% vs 14%) and after (70% vs 51%).
• Caecal intubation rates were high in both groups (96% CO2i, 98% AIRi), with no complications in the CO2i group.

Conclusions:

• CO2 insufflation during colonoscopy effectively reduces pain during and after the examination.
• Improved patient tolerance with CO2 insufflation suggests potential for widespread adoption as a screening tool.