PEDIATRICS

Eduardo Ibarguen-Secchia , MD. *   * Pediatric Digestive Care, San Antonio, TX.
Purpose: To determine safety, tolerability and comfort of use of carbon dioxide for insufflation during colonoscopy in children.
Methods: After informed consent, a total of 84 consecutive patients undergoing colonoscopy were randomized to use either air or CO₂ insufflation. Ages ranged from 6 years to 16 years (mean 12). End tidal carbon dioxide was recorded before the examination, at 2 minute intervals during the examination and 10 minutes after it. General anesthesia was used for sedation in all cases. Pain at 5 and 15 minutes after the procedure was measured using a ten-point analog scale.
Results: Pain scores at 5 minutes after the examination were 5.2 ± 0.3 for the air group and 4.8 ± 0.2 for the CO₂ group (no significant difference). At 15 minutes the score were 2.8 ± 0.3 for the air group and 0.7 ± 0.3 for the CO₂ group (significant at P < 0.05). End tidal CO₂ in both groups was no different.
Conclusion: Using CO₂ for insufflation during colonoscopy is safe and improves patient comfort. Patients who received CO₂ insufflation during their colonoscopy experienced less post-procedure discomfort. There was no evidence of CO₂ retention based on end tidal carbon dioxide monitoring.