Su Young Kim1,2, Jun-Won Chung2, Jung Ho Kim2, Yoon Jae Kim2, Kyoung Oh Kim2, Kwang An Kwon2, Dong Kyun Park2. 1. Divison of Gastroenterology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea. 2. Divison of Gastroenterology, Department of Internal Medicine, Gachon University, Gil Medical Center, Incheon, South Korea.
Abstract
BACKGROUND: Studies of the use of CO2 insufflation during endoscopic resection of large colorectal polyps (LCPs) are lacking. OBJECTIVE: We evaluated the effect of CO2 insufflation on pain after endoscopic resection of LCPs. METHODS: In a prospective randomized controlled trial (RCT), 132 patients were randomly assigned to groups who underwent endoscopic resection with CO2 insufflation (CO2 group, n = 66) or air insufflation (air group, n = 66). The primary outcome was abdominal pain post-procedure (PP). The secondary outcomes were abdominal distension, rates of technical success, amounts of sedatives prescribed, use of analgesics, and adverse events. RESULTS: Baseline patient characteristics were similar between the groups. The mean abdominal pain score was 12.3 in the CO2 group vs. 17.5 in the air group at 1 h PP (p = 0.047). Also, the proportion of patients without pain was significantly higher in the CO2 group at 1 h PP (p = 0.008). The pain score differed more in the endoscopic submucosal dissection group and long-time group. The secondary outcomes were not significantly different between the two groups. CONCLUSIONS: The results of this RCT demonstrate the superiority of CO2 insufflation for endoscopic resection of LCPs in terms of decreasing PP abdominal pain (KCT0001636).
BACKGROUND: Studies of the use of CO2 insufflation during endoscopic resection of large colorectal polyps (LCPs) are lacking. OBJECTIVE: We evaluated the effect of CO2 insufflation on pain after endoscopic resection of LCPs. METHODS: In a prospective randomized controlled trial (RCT), 132 patients were randomly assigned to groups who underwent endoscopic resection with CO2 insufflation (CO2 group, n = 66) or air insufflation (air group, n = 66). The primary outcome was abdominal pain post-procedure (PP). The secondary outcomes were abdominal distension, rates of technical success, amounts of sedatives prescribed, use of analgesics, and adverse events. RESULTS: Baseline patient characteristics were similar between the groups. The mean abdominal pain score was 12.3 in the CO2 group vs. 17.5 in the air group at 1 h PP (p = 0.047). Also, the proportion of patients without pain was significantly higher in the CO2 group at 1 h PP (p = 0.008). The pain score differed more in the endoscopic submucosal dissection group and long-time group. The secondary outcomes were not significantly different between the two groups. CONCLUSIONS: The results of this RCT demonstrate the superiority of CO2 insufflation for endoscopic resection of LCPs in terms of decreasing PP abdominal pain (KCT0001636).
Authors: Klaus Mönkemüller; Helmut Neumann; Peter Malfertheiner; Lucia C Fry Journal: Clin Gastroenterol Hepatol Date: 2009-03-10 Impact factor: 11.382
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