Aim. The aim of this paper was to evaluate the effect of carbon dioxide (CO 2) vs. air insufflation on post-endoscopic retrograde cholangiopancreatography (ERCP) abdominal pain and distension. In addition, we investigated the changes in the partial pressure of endtidal CO 2 (PetCO 2) and the partial pressure of arterial CO 2 (PaCO 2). Methods. From October 2009 to January 2010, all patients admitted to our centre for ERCP were screened for enrollment; the patients recruited were randomised to CO 2 or air insufflation. The patients were asked to rate their abdominal pain intensity and distension using a 100-mm Visual Analogue Scale (VAS) before, in the recovery room and at 1, 3, 6 and 24 hours after the ERCP. All anesthesiological and endoscopic details and complications were evaluated. Results. We included 76 patients, 39 in the Air group and 37 in the CO 2 group. The groups were similar for age, gender, indications and duration of the procedure. Post-procedure mean values of pain (in the recovery room and at 1, 3 and 6 hours) and distension (at recovery room, and at 1 and 3 hours) according to the VAS were significantly reduced in the CO 2 group as compared to the Air group. At baseline, the PetCO 2 values were similar between the two groups while, during the ERCP, they increased significantly in CO 2 group as compared to the Air group; these values were reduced by simply increasing the ventilation. Conclusion. CO 2 insufflation during ERCP significantly reduces post-procedural abdominal pain and distension. Increased PetCO 2 and PaCO 2 values remained within acceptable or readily controllable ranges.

Carbon dioxide insufflation versus air insufflation during endoscopic retrograde cholangiopancreatography under general anesthesia.

MORACE, Carmela;CONSOLO, Pierluigi;ALIBRANDI, Angela;
2011

Abstract

Aim. The aim of this paper was to evaluate the effect of carbon dioxide (CO 2) vs. air insufflation on post-endoscopic retrograde cholangiopancreatography (ERCP) abdominal pain and distension. In addition, we investigated the changes in the partial pressure of endtidal CO 2 (PetCO 2) and the partial pressure of arterial CO 2 (PaCO 2). Methods. From October 2009 to January 2010, all patients admitted to our centre for ERCP were screened for enrollment; the patients recruited were randomised to CO 2 or air insufflation. The patients were asked to rate their abdominal pain intensity and distension using a 100-mm Visual Analogue Scale (VAS) before, in the recovery room and at 1, 3, 6 and 24 hours after the ERCP. All anesthesiological and endoscopic details and complications were evaluated. Results. We included 76 patients, 39 in the Air group and 37 in the CO 2 group. The groups were similar for age, gender, indications and duration of the procedure. Post-procedure mean values of pain (in the recovery room and at 1, 3 and 6 hours) and distension (at recovery room, and at 1 and 3 hours) according to the VAS were significantly reduced in the CO 2 group as compared to the Air group. At baseline, the PetCO 2 values were similar between the two groups while, during the ERCP, they increased significantly in CO 2 group as compared to the Air group; these values were reduced by simply increasing the ventilation. Conclusion. CO 2 insufflation during ERCP significantly reduces post-procedural abdominal pain and distension. Increased PetCO 2 and PaCO 2 values remained within acceptable or readily controllable ranges.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11570/2557453
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