CO ₂ vs. air insufflation in endoscopic ultrasonography: a prospective study

Area of Science:

• Gastroenterology
• Medical Imaging
• Endoscopy

Background:

• Carbon dioxide (CO2) is increasingly used for endoscopic insufflation due to safety and patient tolerance.
• Its role in endoscopic ultrasonography (EUS) remains understudied.

Purpose of the Study:

• To compare the effects of CO2 versus air insufflation on abdominal discomfort during EUS.
• To evaluate the impact of CO2 on EUS image quality, visual artifacts, and sedation requirements.

Main Methods:

• A prospective, controlled, single-blind, observational study involving 198 patients.
• Abdominal discomfort assessed using a visual analogue scale at baseline, and 1 and 3 hours post-EUS.
• Image quality rated on a 4-point scale across four scanning sites.

Main Results:

• CO2 insufflation led to statistically significant less abdominal discomfort at 3 hours post-EUS compared to air (P=0.048).
• No significant difference in sedation dose was observed between groups.
• CO2 significantly improved image quality across all scanning sites (P<0.01) and reduced visual artifacts and the need for suction (P<0.01).

Conclusions:

• EUS with CO2 insufflation is associated with reduced abdominal discomfort and improved image quality compared to air.
• CO2 may offer advantages for diagnostic EUS, warranting further investigation for its potential as a standard of care.