Carbon dioxide insufflation vs conventional air insufflation for colonoscopy: a systematic review and meta‐analysis of published randomized controlled trials

Abstract

CI seems to have clinical advantages over AI for colonoscopy with regard to pain during and after the procedure.

Bayesian network meta‐analysis: Efficacy of air insufflation, CO2 insufflation, water exchange, and water immersion in colonoscopy

“…With the emergence of new colonoscopy techniques, it seemed better than the conventional procedure . Several meta‐analyses suggested that water infusion may reduce pain score compared with air insufflation . The results were confirmed in our meta‐analysis.…”

“…Several meta-analyses suggested that water infusion may reduce pain score compared with air insufflation. 4,5,9 The results were confirmed in our meta-analysis. However, in some points, our analysis was inconsistent with previous results.…”

“…Although there were several meta‐analyses assessing the efficacy and safety between different colonoscopy techniques, many limitations remained. Only CO 2 insufflation versus air insufflation and water infusion versus air insufflation were accomplished without other comparisons.…”

Expert opinions and scientific evidence for colonoscopy key performance indicators

“…There are few subjects researched in endoscopy research where agreement is repeatedly reached in all randomised trials regardless of country and settings,201 202 but the method used to distend the bowel is one such subject. The main effect is on abdominal pain experienced on the day of colonoscopy; this is summarised in three meta-analyses 203–205. Possible restrictions of CO 2 use in patients with chronic obstructive pulmonary disease (COPD) are not well studied, and capnographic measurements in patients without COPD did not show significant CO 2 increases 206–208.…”

Autonomic nervous responses in colorectal polypectomy: Randomized controlled trial comparing air and carbon dioxide insufflation

“…Recently, several clinical reports of CO 2 insufflation for colonoscopy have been reported . A meta‐analysis investigating 21 RCT comprising 3607 colonoscopy patients reported that CO 2 insufflation for colonoscopy could have clinical advantages regarding abdominal pain during and after the procedure . A further meta‐analysis that examined 21 RCT including 13 on colonoscopy also concluded that CO 2 insufflation during colonoscopy causes lower post‐procedural pain and bowel distension without significant pCO 2 variation …”