Efficacy of carbon dioxide versus air insufflation according to different sedation protocols during therapeutic endoscopic retrograde cholangiopancreatography: prospective, randomized, double-blind study
- Abstract
- BACKGROUND AND AIM: Therapeutic endoscopic retrograde cholangiopancreatography (ERCP) tends to require considerable air insufflation, which results in abdominal pain or distension. We investigated the efficacy of carbon dioxide (CO2 ) compared with air insufflation when using two different sedation protocols in therapeutic ERCP. METHODS: Patients who required therapeutic ERCP were randomly assigned to four groups based on preliminary data: air insufflation with balanced propofol sedation (BPS), air with propofol + opioid sedation (PS), CO2 with BPS, and CO2 with PS. Post-ERCP abdominal pain, distension and nausea by the 10-point visual analogue scale (VAS), and gas volume score (GVS) by the four-point ordinal scale were measured according to the time interval. Overall satisfaction with sedation, sedation efficacy, and complications were also measured. RESULTS: The CO2 with BPS group showed lowest mean VAS score for abdominal pain (immediately after recovery, P = 0.002; and 3 h post-ERCP, P = 0.047) and distension (immediately after recovery, P = 0.018; 3 h post-ERCP, P < 0.01; and 24 h post-ERCP, P = 0.042). Overall satisfaction with sedation was greater in the CO2 with BPS group (P = 0.005). Mean GVS at 2 h and 12 h post-ERCP was significantly lower in the CO2 with BPS group (P < 0.05). There were no significant differences in procedure or sedation-related complications. CONCLUSION: CO2 with BPS showed the lowest VAS score for early abdominal pain, distension and GVS, and had a higher score for overall satisfaction for sedation.
- All Author(s)
- S. J. Lee
; T. H. Lee
; S. H. Park
; Y. N. Lee
; Y. Jung
; H. J. Choi
; S. W. Cha
; J. H. Moon
; Y. D. Cho
; S. J. Kim
- Issued Date
- 2015
- Type
- Article
- Keyword
- abdominal pain; air; carbon dioxide; ERCP}}sedation
- ISSN
- 0915-5635
- Citation Title
- Digestive Endoscopy
- Citation Volume
- 27
- Citation Number
- 4
- Citation Start Page
- 512
- Citation End Page
- 521
- Language(ISO)
- eng
- DOI
- 10.1111/den.12448
- URI
- http://schca-ir.schmc.ac.kr/handle/2022.oak/2296
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