Colonoscopy: Randomized Comparative Study of Insufflation With Carbon Dioxide Versus Air

DE-Quadros, Luiz Gustavo; Kaiser-Júnior, Roberto Luiz; Felix, Valter Nilton; Villar, Lucio; Campos, Josemberg Marins; Nogueira, Vinicius Quintiliano Moutinho; Teixeira, André; Zotarelli-Filho, Idiberto José

doi:10.1590/0102-6720201700030004

Cited by 6 publications

(3 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Despite the similarity of intestinal preparation with other retrograde methods, AQ is the only equipment currently available that works with pressure and gravity method 1 , 3 , 12 , 15 . It has advantages over others because it is the only one that works with pressure and gravity system, increasing the efficiency of intestinal lavage.…”

Section: Discussionmentioning

confidence: 99%

New Bowel Preparation Technique for Colonoscopy: Clinical Trial Comparing Aquanet and Mannitol

Kaiser-Júnior

DE-Quadros

Flamini-Júnior

et al. 2018

ABCD, arq. bras. cir. dig.

Self Cite

View full text Add to dashboard Cite

Background:Fifty-five percent of Americans aged 50-65 are submitted to colonoscopy. For over 65-year, this number increases to 64%. In Brazil, it is forecast that the population submitted to colonoscopy will grow, even though inadequate preparation is still a major problem. Aim:To analyze the quality of a new intestinal preparation technique, Aquanet EC-2000®, compared to oral Mannitol solution. Methods:This prospective longitudinal study enrolled 200 patients with indication for colonoscopy. The sample was randomly allocated to two groups of 100; one group received Aquanet EC-2000® to prepare for colonoscopy and the other Mannitol solution. The Boston scale was used to analyze the results. Results:As expected both preparations produced similar results with the bowel cleansing of the different regions of the colon being classified as Boston scale 3 (excellent) in most patients (p>0.05). Conclusion:The results of bowel preparation using Aquanet EC-2000® were similar to using Mannitol solution.

show abstract

Section: Discussionmentioning

confidence: 99%

New Bowel Preparation Technique for Colonoscopy: Clinical Trial Comparing Aquanet and Mannitol

Kaiser-Júnior

DE-Quadros

Flamini-Júnior

et al. 2018

ABCD, arq. bras. cir. dig.

Self Cite

View full text Add to dashboard Cite

show abstract

“…In contrast with our data, the same authors reported lower pain scores 1 h after colonoscopy (as well as 3 and 6 h post-procedure) with CO2-insufflation. In the randomized study of De-Quadros et al (38) , insufflation of CO2 during colonoscopy was superior to RA, as it caused less post-procedure abdominal distension and provided more comfort during the 24 h period after colonoscopy. The medical literature appears to demonstrate the greatest benefit of CO2-insufflation during the first hour post-colonoscopy, and most studies report some benefit up to 6 h after the procedure.…”

Section: Discussionmentioning

confidence: 95%

Volumetric Capnography for Respiratory Monitoring of Patients During Routine Colonoscopy With Room-Air and Carbon Dioxide Insufflation

Camargo

Moreira

Magro

et al. 2022

Arq. Gastroenterol.

View full text Add to dashboard Cite

Background: Capnography and carbon dioxide (CO2) insufflation during gastrointestinal endoscopy under sedation are associated with safety and comfort improvements, respectively. Capnography can provide early detection of apnea and hypoxemia, whereas CO2 insufflation causes lower periprocedural discomfort. This is the first study to report the application of volumetric capnography in colonoscopy. Objective: This study aimed to evaluate the use of volumetric capnography with room air (RA) and CO2 insufflation during routine colonoscopy. Methods: In this prospective cohort study, 101 patients who underwent routine colonoscopy under sedation with volumetric capnography monitoring were included. Insufflation with RA was used to distend the intestinal lumen in group 1 (n=51), while group 2 (n=50) used CO2 insufflation. The primary endpoints were episodes of hypoxia, alveolar hypoventilation, and end-tidal CO2 (EtCO2). The secondary endpoints were tidal volume per minute, consumption of sedation medications, and post-procedure pain using the Gloucester modified pain scale. Results: The number of episodes of hypoxia (SpO2<90%) was similar between the groups: four episodes in Group 1 and two episodes in Group 2. The duration of hypoxia was significantly longer in group 2 (P=0.02). Hypoalveolar ventilation (EtCO2) occurred more frequently in Group 2 than in Group 1 (27 vs 18 episodes, P=0.05). Regarding EtCO2, Group 2 showed higher values in cecal evaluation (28.94±4.68 mmHg vs 26.65±6.12 mmHg, P=0.04). Regarding tidal volume per minute, Group 2 had significantly lower values at the cecal interval compared to Group 1 (2027.53±2818.89 vs 970.88±1840.25 L/min, P=0.009). No episodes of hypercapnia (EtCO2 > 60 mmHg) occurred during the study. There was no difference in the consumption of sedation medications between the groups. Immediately after colonoscopy, Group 2 reported significantly less pain than Group 1 (P=0.05). Conclusion: In our study, volumetric capnography during colonoscopy was feasible and effective for monitoring ventilatory parameters and detecting respiratory complications. CO2 insufflation was safe and associated with less pain immediately after colonoscopy.

show abstract

“…However, pain sensation or change in heart rate (as a surrogate marker for pain) is not included in the Aldrete scoring system. Discomfort or pain is a frequent finding after gastrointestinal endoscopy due to stomach or bowel distention, although the procedure is better tolerated after CO 2 insufflation that after air insufflation [7]. Also, the fact that patients are taking antihypertensive or antiarrhythmic medication (e. g. betablockers) is not included in the Aldrete scoring system.…”

Section: Discussionmentioning

confidence: 99%

Implementation of the Aldrete score reduces recovery time after non-anesthesiologist-administered procedural sedation in gastrointestinal endoscopy

et al. 2022

View full text Add to dashboard Cite

Background and study aims Procedural sedation and analgesia (PSA) by trained non-anesthesiologist physicians and/or nurses is often performed during endoscopic procedures. Discharge from the recovery area after monitored observation is frequently based on fixed time parameters or subjective clinical assessment. In this study, the effect of implementation of the Aldrete score on recovery time after procedural sedation was analyzed in a real-life setting. Patients and methods A prospective observational study of patients undergoing procedural sedation and analgesia during gastroscopy, colonoscopy or endoscopic ultrasound was performed. All procedures were randomly included to represent a real-life situation with different endoscopists, recovery nurses, endoscopy systems and indications. After a first observation period, all endoscopy nurses were trained to implement the Aldrete score when discharging patients, followed by a second observation period. Results During the first observation period, the average time spent in the recovery area was 59 ± 22 minutes after procedural sedation. After implementation of the Aldrete score, the recovery time decreased significantly to 47 ± 25 minutes (P < 0.01) with identical doses of procedural sedation and analgesia. The decrease in time was between 19 % and 35 % for the different endoscopic procedures. Conclusions Implementation of the Aldrete score after procedural sedation and analgesia significantly reduces the time spent in the recovery area. The score can be used to safely implement a discharge policy that provides more efficient and standardized management for an endoscopy service.

show abstract

Colonoscopy: Randomized Comparative Study of Insufflation With Carbon Dioxide Versus Air

Cited by 6 publications

References 23 publications

New Bowel Preparation Technique for Colonoscopy: Clinical Trial Comparing Aquanet and Mannitol

New Bowel Preparation Technique for Colonoscopy: Clinical Trial Comparing Aquanet and Mannitol

Volumetric Capnography for Respiratory Monitoring of Patients During Routine Colonoscopy With Room-Air and Carbon Dioxide Insufflation

Implementation of the Aldrete score reduces recovery time after non-anesthesiologist-administered procedural sedation in gastrointestinal endoscopy

Contact Info

Product

Resources

About