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International Journal of Colorectal Disease

Published in:

01-06-2016 | Original Article

A randomized controlled trial comparing water exchange and air insufflation during colonoscopy without sedation

Authors: Makoto Arai, Kenichiro Okimoto, Hideaki Ishigami, Takashi Taida, Arata Oyamada, Shoko Minemura, Keiko Saito, Masaru Tsuboi, Daisuke Maruoka, Tomoaki Matsumura, Tomoo Nakagawa, Tatsuro Katsuno, Kanae Mitsuhashi, Yuki Nakagawa, Kazuya Yamaguchi, Osamu Yokosuka

Published in: International Journal of Colorectal Disease | Issue 6/2016

Abstract

Objectives

Previous studies have shown that water exchange is superior to air insufflation in attenuating insertion pain during colonoscopy. We conducted a randomized controlled trial with head-to-head comparison of these methods to assess their effectiveness in colonoscopy without sedation.

Methods

A total of 447 outpatients were randomized to either water exchange (WE) or the standard air (CO₂) insufflation (AI). The primary outcome was the improvement of patient intraprocedural pain (pain score), evaluated using a questionnaire (scores 1 to 5).

Results

After exclusion of 44 patients from further analysis, 403 patients were analyzed. There was no difference in clinical background between the WE and AI groups. Patients in the WE group reported less intraprocedural pain than those in the AI group (2.17 ± 1.06 vs. 2.42 ± 1.03; unpaired t test, p = 0.021). We divided the cases into two groups, more or less painful colonoscopy, based on age, body mass index, use of anti-peristaltic drugs or not, and physician’s experience. In less painful colonoscopy, the WE method could reduce pain effectively but its effect was limited in the more painful group.

Conclusion

WE is superior to AI for attenuating insertion pain during colonoscopy without sedation, but its efficacy is limited in more painful endoscopy.

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Title: A randomized controlled trial comparing water exchange and air insufflation during colonoscopy without sedation
Authors: Makoto Arai
Kenichiro Okimoto
Hideaki Ishigami
Takashi Taida
Arata Oyamada
Shoko Minemura
Keiko Saito
Masaru Tsuboi
Daisuke Maruoka
Tomoaki Matsumura
Tomoo Nakagawa
Tatsuro Katsuno
Kanae Mitsuhashi
Yuki Nakagawa
Kazuya Yamaguchi
Osamu Yokosuka
Publication date: 01-06-2016
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 6/2016
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-016-2580-z

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

A randomized controlled trial comparing water exchange and air insufflation during colonoscopy without sedation

Abstract

Objectives

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

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