Carbon dioxide insufflation during endoscopic retrograde cholangiopancreatography reduces bowel gas volume but does not affect visual analogue scale scores of suffering: a prospective, double-blind, randomized, controlled trial

Kuwatani, Masaki; Kawakami, Hiroshi; Hayashi, Tsuyoshi; Ishiwatari, Hirotoshi; Kudo, Taiki; Yamato, Hiroaki; Ehira, Nobuyuki; Haba, Shin; Eto, Kazunori; Kato, Mototsugu; Asaka, Masahiro

Carbon dioxide insufflation during endoscopic retrograde cholangiopancreatography reduces bowel gas volume but does not affect visual analogue scale scores of suffering: a prospective, double-blind, randomized, controlled trial

Kuwatani, Masaki; Kawakami, Hiroshi; Hayashi, Tsuyoshi et al.

Surgical Endoscopy, 2011, 25(12), 3784-3790

Permalink : https://hdl.handle.net/2115/50764

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アクセス権	open access
URI	https://hdl.handle.net/2115/50764
タイトル	Carbon dioxide insufflation during endoscopic retrograde cholangiopancreatography reduces bowel gas volume but does not affect visual analogue scale scores of suffering: a prospective, double-blind, randomized, controlled trial
著者	Kuwatani, Masaki ; Kawakami, Hiroshi ; Hayashi, Tsuyoshi ; Ishiwatari, Hirotoshi ; Kudo, Taiki ; Yamato, Hiroaki ; Ehira, Nobuyuki ; Haba, Shin ; Eto, Kazunori ; Kato, Mototsugu ; Asaka, Masahiro
e-Rad_Researcher 50431375 著者名 Kuwatani, Masaki
e-Rad_Researcher 80399823 著者名 Kawakami, Hiroshi
著者名 Hayashi, Tsuyoshi
著者名 Ishiwatari, Hirotoshi
著者名 Kudo, Taiki
著者名 Yamato, Hiroaki
著者名 Ehira, Nobuyuki
著者名 Haba, Shin
著者名 Eto, Kazunori
e-Rad_Researcher 60271673 著者名 Kato, Mototsugu
e-Rad_Researcher 10113507 著者名 Asaka, Masahiro
言語	英語
キーワード	Carbon dioxide insufflation
	Air insufflation
	Conscious sedation
	Endoscopic retrograde cholangiopancreatography
	Gas volume score
発行日	2011-12
出版者	Springer-Verlag
収録物名	Surgical Endoscopy
巻(号)	25(12)
ページ	3784-3790
抄録	Background: Endoscopic retrograde cholangiopancreatography (ERCP) and related procedures can cause abdominal pain and discomfort. Two clinical trials have indicated, using the visual analogue scale (VAS) score, that CO2 insufflation during ERCP ameliorates the suffering of patients without complications, as compared with air insufflation. However, differences in patient suffering between CO2 and air insufflation after ERCP under deep conscious sedation have not been reported. We focused on the gas volume score (GVS) as an objective indicator of gas volume, and designed a multicenter, prospective, double-blind randomized controlled study with CO2 and air insufflation during ERCP. Methods: Between March 2010 and August 2010, 80 patients who required ERCP were enrolled and evenly randomized to receive CO2 insufflation (CO2 group) or air insufflation (air group). ERCP and related procedures were performed under deep conscious sedation with fentanyl citrate or pethidine and midazolam or diazepam. The GVS was evaluated as the primary endpoint in addition to the VAS score as the secondary endpoint. Results: The GVS after ERCP and related procedures in the CO2 group was significantly lower than that in the air group (0.14 ± 0.06 vs. 0.31 ± 0.11, P < 0.01), as well as the increase in the rate of GVS ([GVS after - GVS before] / [GVS before ERCP and related procedures] x 100) (3.8 ± 5.9 vs. 21.0 ± 11.1%, P < 0.01). VAS scores 3 and 24 hours after ERCP and related procedures were comparable between the CO2 and air groups for abdominal pain, abdominal distension, and nausea. Additionally, VAS scores were not correlated with the GVS. Conclusions: CO2 insufflation during ERCP reduces GVS (bowel gas volume), but not the VAS score of suffering, as compared with air insufflation. Deep and sufficient sedation during ERCP and related procedures is important for the palliation of patients' pain and discomfort.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
権利情報	The original publication is available at www.springerlink.com
PISSN	0930-2794
関連情報	PMID 21656068
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1007/s00464-011-1789-8