Insufflation of Carbon Dioxide versus Air During Colonoscopy Among Pediatric Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Background/Aims: Carbon dioxide is increasingly used in insufflation during colonoscopy in adult patients; however, air insufflation remains the primary practice among pediatric gastroenterologists. This systematic review and meta-analysis aims to evaluate insufflation using CO2 versus air in colono...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Society of Gastrointestinal Endoscopy
2021-03-01
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| Series: | Clinical Endoscopy |
| Subjects: | |
| Online Access: | http://www.e-ce.org/upload/pdf/ce-2020-275.pdf |
| Summary: | Background/Aims: Carbon dioxide is increasingly used in insufflation during colonoscopy in adult patients; however, air insufflation remains the primary practice among pediatric gastroenterologists. This systematic review and meta-analysis aims to evaluate insufflation using CO2 versus air in colonoscopies in pediatric patients. Methods: Individualized search strategies were performed using MEDLINE, Cochrane Library, EMBASE, and LILACS databases following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and Cochrane working methodology. Randomized control trials (RCTs) were selected for the present meta-analysis. Pooled proportions were calculated for outcomes including procedure time and abdominal pain immediately and 24 hours post-procedure. Results: The initial search yielded 644 records, of which five RCTs with a total of 358 patients (CO2: n=178 versus air: n=180) were included in the final analysis. The procedure time was not different between the CO2 and air insufflation groups (mean difference, 10.84; 95% confidence interval [CI], -2.55 to 24.22; p=0.11). Abdominal pain immediately post-procedure was significantly lower in the CO2 group (risk difference [RD], -0.15; 95% CI; -0.26 to -0.03; p=0.01) while abdominal pain at 24 hours post-procedure was similar (RD, -0.05; 95% CI; -0.11 to 0.01; p=0.11). Conclusions: Based on this systematic review and meta-analysis of RCT data, CO2 insufflation reduced abdominal pain immediately following the procedure, while pain was similar at 24 hours post-procedure. These results suggest that CO2 is a preferred insufflation technique when performing colonoscopy in pediatric patients. |
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| ISSN: | 2234-2400 2234-2443 |