Original articleClinical endoscopyRandomized, double-blind trial of CO2 versus air insufflation in children undergoing colonoscopy

Background and AimsStudies in adults have shown that postprocedural abdominal pain is reduced with the use of carbon dioxide (CO2) instead of air for insufflation during colonoscopy. The aim of our study was to compare postprocedural abdominal pain and girth in children undergoing colonoscopy using CO2 or air for insufflation.MethodsThis was a prospective, randomized, double-blind study that included 76 consecutive pediatric patients undergoing colonoscopy for various indications. Patients were randomly assigned to either CO2 or air insufflation. At 2, 4, and 24 hours after the examination, the patients' pain was assessed by using the 11-point numerical rating scale. The waist circumference was measured 10 minutes and 2 and 4 hours after colonoscopy.ResultsA significantly higher proportion of patients had no pain after colonoscopy in the CO2 group compared with the air group (82 vs 37% at 2 hours and 95% vs. 63% at 4 hours, P < .001). Mean abdominal pain scores 2 and 4 hours after the procedure were statistically significantly lower in the CO2 group compared with the control air group (0.5 vs 2.6 at 2 hours and 0.1 vs 1.2 at 4 hours, P < .001). There was no difference in waist circumference between the 2 groups at all time intervals.ConclusionThe results of this randomized trial show clear benefits of CO2 insufflation for colonoscopy in reducing postprocedural discomfort. (Clinical trial registration number: NCT02407639.)