A Research Of Carbon Dioxide Insufflation For Efficacy And Safety In Painless Colonoscopic Polypectomy

Objectives:In order to explore the efficacy and safety of carbon dioxide insufflation during painless colonoscopy,and the superiority of carbon dioxide insufflation to air insufflation in the procedure.Methods:In a radomizde, double-blinded design, A total of 90 consecutive patients undergoing anesthesia colonoscopy polyp resection were assigned to the use of either CO2 or AIR insufflation.Midazolam was administrated according to the weight grade of each patient and the dosage of propofol was recorded.Heart rate (HR),respiratory rate(RR), arterial oxygen saturation (SPO2),end tidal CO2 (ETCO2), systolic blood pressure (SBP), diastolic blood pressure (DBP) were recorded at the beginning,coecum,recturn and end of the procedure.The patient's abdominal pain,abdominal distention and anus exhausting 1,3,6 and 24h afterwards was registered using a questionnaire. The satisfaction degree of the examiners and patients were also recorded.Results:1.Dosage comparison of propofol:graded all the patients by their weight and assume the dosage of midazolam:lower limit of weight in every grade plus 0.03mg/kg. The dosage of propofol:CO2 group 189.5±24.6mg, AIR group 194.6±22.8mg,no statistic significance (P=0.137).2. Comparison of painless colonoscopy procedure:All of the patients had complete painless colonoscope.The degree of intestinal preparation was 1.9 in CO2 group and 1.8 in AIR group,no statistics significance (P=0.267).The time of procedure was 37.07 min in CO2 group and 39.88 min in AIR group, no statistics significance (P=0.190).There was no difference in the amount of biopsy,the degree of satisfaction in patients or examiners of the two groups.All the patients had no memory of the procedure.3.Comparison of HR,RR,SPO2,ETCO2,SBP and DBP:HR, RR, ETCO2, SBP and DBP were changed during the procedure,but recovery to the baseline level at the end,there was no statistic significance between the two groups at the four time points(P>0.05),but significant in the comparison between coecum and beginning,recturn and beginning in each group(P<0.05),no significance in the end and beginning comparison(P>0.05). SPO2 changed little during the procedure.4.Abdominal pain,distention and anus exhausting:Successfully arranged 67 patients in CO2 group and 69 patients in AIR group.There were less patients having abdominal pain at the end of the procedure, 1,3,6h afterwards in the CO2 group (P<0.05),no difference 24h afterwards(P=0.324).The number of patients having abdominal distention was larger in AIR group(P<0.0001);the release time was 0.92±1.16h in CO2 group and 3.54±3.53h in AIR group(P<0.0001).There were much less anus exhausting in the CO2 group than that of AIR group 1,3,6h afterwards(P<0.05),but no difference 24h afterwards(P=0.182). Conclusions:Carries on the polyp electrotomy under the anaesthesia colon mirror polyp using the carbon dioxide is one kind effective and safe method,which Can effectively reduce postoperative abdominal pain and bloating and does not cause carbon dioxide retention.