Is CO2 insufflation an amelioration of routine colonoscopy?

The insufflation of gas during colonoscopy leads to distention of the colon with abdominal discomfort and pain for the patients. Use of CO2 during endoscopy is reported to minimize abdominal discomfort during and after endoscopy. Aim of this study was to find out whether this improvement leads to decreased dosage of sedation drugs in order to improve patient's safety and satisfaction.

In this double-blind, randomized and controlled study 150 Patients referred to colonoscopy were assigned to either CO2 or air insufflation. We recorded basic characteristics of colonoscopy and the amount of drugs used for sedation. Patients and investigators filled out questionnaires to record pain, abdominal bloating and flatulence.

Seventy-two patients were randomized for examination with room air, 78 patients for use of CO2. We found no difference in basic characteristics of colonoscopy (cecal intubation time and procedure time). Both groups were administered the same amount of drugs for sedation. We found only slight improvement of pain, abdominal bloating and flatulence.

The study revealed only moderate positive effects for use of CO2 during colonoscopy. We found only modest improvement of patient's comfort during and after colonoscopy. No reduced doses of drugs for sedation could be recorded.