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Dig Dis Sci (2010) 55:20352042 DOI 10.1007/s10620-010-1210-9
ORIGINAL ARTICLE
Limited Low-Air Insufation Is Optimal for Colonoscopy
Yu-Hsi Hsieh Kuo-Chih Tseng Hwai-Jeng Lin
Received: 1 November 2009 / Accepted: 21 March 2010 / Published online: 22 April 2010 Springer Science+Business Media, LLC 2010
AbstractBackground Air insufation is essential in routine colonoscopy, but obtaining optimal insufation levels has not been discussed in the literature. The aim of this study was to determine optimal air insufation during colonoscopic examination.
Methods Consecutive patients who underwent colonos-copy were randomized to receive high-air insufation (group A, n = 83), low-air insufation (group B, n = 84), or low-air insufation limited to the rectum and sigmoid colon (group C, n = 83). Completion rate, cecal intubation time, propofol dose, need for abdominal compression, and turning of patients, were evaluated. The post-procedure abdominal bloating was assessed with a 010 visual analog scale.
Results The completion rates were similar among the three groups. The cecal intubation time was signicantly shorter in group C than in group B (4.1 1.7 min vs.5.2 3.0 min, mean SD, p = 0.005). The dose of propofol was signicantly less in group C than in group A (11.7 3.2 mg vs. 12.7 3.6 mg, mean SD, p =0.045). Group C needed the least manual abdominal compression (group A, B, and C: 81.9, 69, and 59%, respectively, p = 0.005) and had the least post-procedure abdominal bloating (group A, B, and C: 2.2 2.4, 2.2 2.1, and 1.5 1.9, respectively, p = 0.04).
Conclusions We found that limited use of low-air insufation in the rectum and sigmoid is the procedure of choice for colonoscopic examination.
Keywords Air pressure Propofol Colonoscopy
Intubation time
Introduction
Colonoscopy is currently the gold standard for evaluating colon disease [1, 2]. However, the procedure can sometimes be difcult and the success rate of intubation varies with the skills of the endoscopist [3]. Various methods have been used to improve colonoscopy such as variable stiffness colonoscopes, magnetic endoscopic imaging, water intubation, and oil lubrication [47]. Some of these measures require new instruments, which, unfortunately, are controversial.
Part of the difculty of inserting the colonoscope may be due to colon elongation by air insufation. The old instruction was to inate as much as necessary but as little...