Randomized, double-blind trial of CO2 versus air insufflation in children undergoing colonoscopy

Area of Science:

• Pediatric Gastroenterology
• Endoscopic Procedures
• Pain Management

Background:

• Post-colonoscopy abdominal pain is a common concern in pediatric patients.
• Previous studies in adults suggest carbon dioxide (CO(2)) reduces post-procedural pain compared to air insufflation.
• The efficacy of CO(2) for pain reduction in pediatric colonoscopy remained to be established.

Purpose of the Study:

• To compare post-procedural abdominal pain and girth in children undergoing colonoscopy.
• To evaluate the effectiveness of carbon dioxide (CO(2)) versus air insufflation for pediatric colonoscopy.

Main Methods:

• Prospective, randomized, double-blind study involving 76 pediatric patients.
• Patients were randomized to receive either CO(2) or air for insufflation during colonoscopy.
• Pain was assessed using a numerical rating scale at 2, 4, and 24 hours post-procedure; waist circumference was measured.

Main Results:

• A significantly higher proportion of patients in the CO(2) group reported no pain at 2 and 4 hours post-colonoscopy (82% vs. 37% and 95% vs. 63%, respectively).
• Mean abdominal pain scores were significantly lower in the CO(2) group at 2 and 4 hours.
• No significant difference in waist circumference was observed between the CO(2) and air groups.

Conclusions:

• Carbon dioxide (CO(2)) insufflation offers significant benefits in reducing post-procedural discomfort for children undergoing colonoscopy.
• CO(2) is a superior alternative to air for insufflation in pediatric colonoscopy, enhancing patient recovery.
• This randomized trial supports the routine use of CO(2) for pediatric colonoscopy to minimize patient discomfort.