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A randomized controlled study comparing room air with carbon dioxide for abdominal pain, distention, and recovery
Yen-Ju Chen1, Jennifer Lee, Magaly Puryear
1Yen-Ju Chen, RN, CGRN, MSN, is Clinic Nurse Manager, Gastroenterology Service, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland. Jennifer Lee, RN, CGRN, is retired Clinic Nurse Manager, Gastroenterology Service, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland. Magaly Puryear, RN, is Clinic Nurse Manager, Gastroenterology Service, Department of Medicine, Fort Belvoir Community Hospital, Fort Belvoir, Virginia. Roy K. H. Wong, MD, is retired Chief, Gastroenterology Service, Department of Medicine, Walter Reed National Military Medical Center, and Uniformed Service University of the Health Sciences, Bethesda, Maryland. Jason M. Lake, MD, is Staff Physician, Gastroenterology Service, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland. Corrine L. Maydonovitch, BS, is Chemist, Gastroenterology Service, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland. Lavern Belle, BS, is Clinical Coordinator, Gastroenterology Service, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland. Fouad J. Moawad, MD, is Major, Medical Corps, US Army, Director of Gastrointestinal Research, Motility and Reflux Testing Lab, Walter Reed National Military Medical Center, and Assistant Professor of Medicine, Uniformed Services University, Bethesda, Maryland.
Abstract:
Colonoscopy remains the gold standard for colorectal cancer screening. Many barriers to the procedure exist including the possibility of abdominal discomfort that may occur with insufflation. Carbon dioxide (CO2), which is rapidly absorbed in the blood stream, is an alternate method used to distend the lumen during colonoscopy. The goal of this study was to compare patient discomfort, abdominal girth, and recovery time in 2 groups of patients randomized to CO2 versus room air insufflation during colonoscopy. Using a Wong-Baker score, we found statistical difference in postprocedural discomfort levels (CO2 Group: 1.15 ± 2.0 vs. room air: 0.41 ± 0.31, p = .015) and a significantly greater increase in abdominal girth over CO2 immediately postprocedure (room air: 1.06 ± 1.29 inches vs. CO2: 0.56 ± 0.73 inches, p = .054) girth immediately postprocedure; however, recovery time was similar between the 2 study arms (CO2: 9.1 ± 16.2 minutes vs. room air: 10.2 ± 18.6 minutes, p = .713). Further studies are needed to determine whether CO2 is cost-effective and improves patient satisfaction with colonoscopy.
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