| A randomized, controlled, double-blind trial of air insufflation versus carbon dioxide insufflation during ERCP. | |
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MedLine Citation:
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PMID: 20493485 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Visualization during GI endoscopy requires distention of the bowel lumen. Carbon dioxide (CO(2)) insufflation decreases postprocedure abdominal discomfort and distension after colonoscopy, but there have been few published studies on its use in ERCP. OBJECTIVE: To assess the safety and efficacy of CO(2) insufflation during ERCP. DESIGN: Double-blind, controlled, randomized trial. SETTING: Tertiary-care referral center. PATIENTS: This study involved consecutive patients referred for ERCP, excluding those with known CO(2) retention or with chronic use of opiate medications. INTERVENTION: Insufflation of CO(2) versus insufflation of air. MAIN OUTCOME MEASUREMENTS: Primary outcomes were abdominal pain assessed on a visual analogue scale and abdominal distension. Secondary outcomes included transcutaneous CO(2) levels (pCO(2)) and procedural complications. RESULTS: We analyzed 74 patients, 38 in the air group and 36 in the CO(2) group. Pain scores were similar in both groups 1-hour postprocedure (16 vs 11 mm in the CO(2) and air groups, respectively; P = .29) as well as over the subsequent 24 hours. There were also no significant differences between groups in abdominal distension or pCO(2) levels. There were 13 patients with complications in the air group and 5 in the CO(2) group (P = .04; nominal significance removed by Bonferroni correction), although most complications were minor in nature. LIMITATIONS: Single-center study. CONCLUSION: The use of CO(2) for insufflation during ERCP was safe in a tertiary-care referral population. However, use of CO(2) during ERCP did not lead to decreased postprocedural pain or less abdominal distension, so its role in this procedure remains in question. NCT00685386. |
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Authors:
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Evan S Dellon; Arumugam Velayudham; Bridger W Clarke; Kim L Isaacs; Lisa M Gangarosa; Joseph A Galanko; Ian S Grimm |
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Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2010-05-20 |
Journal Detail:
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Title: Gastrointestinal endoscopy Volume: 72 ISSN: 1097-6779 ISO Abbreviation: Gastrointest. Endosc. Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-07-12 Completed Date: 2010-11-02 Revised Date: 2011-08-01 |
Medline Journal Info:
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Nlm Unique ID: 0010505 Medline TA: Gastrointest Endosc Country: United States |
Other Details:
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Languages: eng Pagination: 68-77 Citation Subset: IM |
Copyright Information:
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Copyright 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved. |
Affiliation:
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Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina 27599-7080, USA. edellon@med.unc.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Abdominal Pain
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etiology Adolescent Adult Aged Aged, 80 and over Air* Capnography / instrumentation Carbon Dioxide* Cholangiopancreatography, Endoscopic Retrograde / instrumentation*, methods* Double-Blind Method Equipment Design Female Humans Male Middle Aged North Carolina Pain Measurement Pneumoradiography / methods* Young Adult |
| Grant Support | |
ID/Acronym/Agency:
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KL2 RR025746-02/RR/NCRR NIH HHS; KL2RR025746/RR/NCRR NIH HHS; T32 DK007634/DK/NIDDK NIH HHS; T32 DK007634-20/DK/NIDDK NIH HHS |
| Chemical | |
Reg. No./Substance:
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124-38-9/Carbon Dioxide |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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