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International Journal of Colorectal Disease

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01-03-2020 | Colonoscopy | Original Article

A meta-analysis of carbon dioxide versus room air insufflation on patient comfort and key performance indicators at colonoscopy

Authors: Ailín C Rogers, Dayna Van De Hoef, Shaheel M Sahebally, Des C Winter

Published in: International Journal of Colorectal Disease | Issue 3/2020

Abstract

Background

Carbon dioxide (CO₂) has been used as an alternative to air insufflation at endoscopy with good results; however, uptake of the technique has been poor, possibly due to perceived lack of outcome equivalency. This meta-analysis evaluates the effectiveness of CO₂ versus air in reducing pain post-colonoscopy and furthermore examines other key performance indicators (KPIs) such as sedative use, procedure times and polyp detection rates.

Methods

This meta-analysis was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Pubmed, Pubmed Central, Embase and Cochrane Library were searched for randomized studies from 2004 to 2019, reporting outcomes for patients undergoing colonoscopy with air or CO₂ insufflation, who reported pain on a numerical or visual analogue scale (VAS). Results were reported as mean differences (MD) or pooled odds ratios (OR) with 95% confidence intervals (95% CI).

Results

Of 3586 citations, 23 studies comprising 3217 patients were analysed. Patients undergoing colonoscopy with air insufflation had 30% higher intraprocedural pain scores than those receiving CO₂ (VAS 3.4 versus 2.6, MD -0.7, 95% CI − 1.4–0.0, p = 0.05), with a sustained beneficial effect amongst those in the CO₂ group at 30 min, 1–2-h and 6-h post procedure (MD − 0.8, − 0.6 and − 0.2, respectively, p < 0.001 for all), as well as less distension, bloating and flatulence (p < 0.01 for all). There were no differences between the two groups in KPIs such as the sedation required, procedure time, caecal intubation or polyp detection rates.

Conclusions

CO₂ insufflation improves patient comfort without compromising colonoscopic performance.

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Title: A meta-analysis of carbon dioxide versus room air insufflation on patient comfort and key performance indicators at colonoscopy
Authors: Ailín C Rogers
Dayna Van De Hoef
Shaheel M Sahebally
Des C Winter
Publication date: 01-03-2020
Publisher: Springer Berlin Heidelberg
Keyword: Colonoscopy
Published in: International Journal of Colorectal Disease / Issue 3/2020
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-019-03470-4

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

A meta-analysis of carbon dioxide versus room air insufflation on patient comfort and key performance indicators at colonoscopy

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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