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Meta-analysis: the use of carbon dioxide insufflation vs. room air... » Isaúde
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Alimentary Pharmacology and Therapeutics
2012-03-27 09:34:27

Meta-analysis: the use of carbon dioxide insufflation vs. room air insufflation for gastrointestinal endoscopy

Descrição: BackgroundCarbon dioxide (CO2) insufflation has been proposed as an alternative to air insufflation to distend the lumen in gastrointestinal (GI) endoscopy.AimTo perform a systematic review with meta-analysis of randomised controlled trials (RCTs) in which CO2 insufflation was compared with room air insufflation in GI endoscopy.MethodsElectronic and manual searches were combined to search RCTs. After methodological quality assessment and data extraction, the efficacy and safety of CO2 insufflation were systematically assessed.ResultsTwenty-one RCTs [13 on colonoscopy, four on endoscopic retrograde cholangiopancreatography (ERCP), two on double-balloon enteroscopy (DBE), one on oesophagogastroduodenoscopy, and one on flexible sigmoidoscopy] were identified. For colonoscopy, CO2 insufflation resulted lower postprocedural pain intensity, and increased the proportion of patient without pain at 1?h (RR: 1.84, 95% CI: 1.37-2.47) and 6?h (RR: 1.28; 95% CI: 1.14-1.44) postprocedure. For ERCP, the pain-releasing effect of CO2 insufflation was not obvious (SMD: -1.48, 95% CI: -3.56, 0.59). CO2 insufflation revealed no consistent advantages in the RCTs of DBE, but was shown as safe as air insufflation in oesophagus/stomach endoscopic submucosal dissection in one study. pCO2 level showed no significant variation during these procedures.ConclusionsCompared with air insufflation, CO2 insufflation during colonoscopy causes lower postprocedural pain and bowel distension without significant pCO2 variation. More RCTs are needed to assess its advantages in other GI endoscopic procedures.

Editorial: John Wiley & Sons, Inc.
Seção: Meta-analysis
Volume: 0
Página: n/a a n/a

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