Combination of water immersion and carbon dioxide insufflation for minimal sedation colonoscopy: a prospective, randomized, single-center trial

European Journal of Gastroenterology & Hepatology
Přemysl FaltOndřej Urban

Abstract

Water immersion insertion and carbon dioxide (CO2) insufflation, as alternative colonoscopic techniques, are able to reduce patient discomfort during and after the procedure. We assessed whether the combination of water immersion and CO2 insufflation is superior in efficacy and patient comfort to other colonoscopic techniques. In a prospective, randomized study, a total of 420 patients were randomized to either water immersion insertion and CO2 insufflation during withdrawal (water/CO2), water insertion and air insufflation during withdrawal (water/air), CO2 insufflation during both insertion and withdrawal (CO2/CO2), or air insufflation during both insertion and withdrawal (air/air). The main outcome was the success of minimal sedation colonoscopy, which was defined as reaching the cecum without switching to another insertion method and without additional sedation beyond the initial 2 mg of midazolam. Patient comfort during and after the procedure was assessed. A total of 404 patients were analyzed. The success rate of minimal sedation colonoscopy in the water insertion arm (water/CO2 and water/air) was 97% compared with 83.3% in the gas insertion arm (CO2/CO2 and air/air; P<0.0001). Intraprocedural pain and bloating were sign...Continue Reading

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Citations

Mar 13, 2014·Current Treatment Options in Gastroenterology·Nicholas Tutticci, Michael J Bourke
Jun 5, 2015·Journal of Crohn's & Colitis·Přemysl FaltMartin Hill
Oct 18, 2016·Clinical Endoscopy·Hyun Gun Kim
Jan 16, 2018·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Zhen ZhangXimo Wang
May 27, 2015·The Cochrane Database of Systematic Reviews·Susanne HafnerOliver Zolk
Jul 3, 2013·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Přemysl FaltOndřej Urban
Nov 16, 2016·European Journal of Gastroenterology & Hepatology·Přemysl FaltOndřej Urban
Nov 14, 2014·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·M S SajidW F A Miles
Feb 4, 2016·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Muhammed A MemonShahjahan Khan
Jun 16, 2015·World Journal of Gastroenterology : WJG·Shinya Sugimoto, Takeshi Mizukami
Feb 17, 2017·Current Treatment Options in Gastroenterology·Sergio Cadoni, Felix W Leung
Jul 4, 2013·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·P FaltO Urban

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