Document Detail


A randomized, controlled, double-blind trial of air insufflation versus carbon dioxide insufflation during ERCP.
MedLine Citation:
PMID:  20493485     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
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:
Title:  Gastrointestinal endoscopy     Volume:  72     ISSN:  1097-6779     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-12     Completed Date:  2010-11-02     Revised Date:  2011-08-01    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  68-77     Citation Subset:  IM    
Copyright Information:
Copyright 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
Affiliation:
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
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MeSH Terms
Descriptor/Qualifier:
Abdominal Pain / 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:
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:
124-38-9/Carbon Dioxide
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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