• Fumihito Hirai, Takahiro Beppu, Taku Nishimura, Noritaka Takatsu, Shinya Ashizuka, Takehiko Seki, Takashi Hisabe, Takashi Nagahama, Kenshi Yao, Toshiyuki Matsui, Tsuyoshi Beppu, Rikiya Nakashima, Naomi Inada, Eriko Tajiri, Hideko Mitsuru, and Hideko Shigematsu.
• Department of Gastroenterology, Fukuoka University Chikushi Hospital, 1-1-1, Zokumyoin, Chikushino, Japan.
• Gastrointest. Endosc. 2011 Apr 1;73(4):743-9.

BackgroundFew studies have evaluated the degree of pain, the amount of retained gas, and the safety of carbon dioxide (CO(2)) insufflation in patients undergoing double-balloon enteroscopy (DBE).ObjectiveTo clarify the usefulness and safety of CO(2) insufflation during DBE.DesignSingle-center, prospective, randomized, double-blind, controlled trial.SettingUniversity hospital.PatientsForty eligible patients with small-bowel disease for whom DBE was indicated were randomized to a CO(2) insufflation (CO(2)) group or an air insufflation (air) group by means of sealed envelopes.InterventionDBE with insufflation of CO(2) or air.Main Outcome MeasurementsEfficacy evaluation was based on the degree of pain as assessed by use of a visual analog scale (VAS) and the amount of residual gas retention within the small and large bowels on radiography. The safety of CO(2) insufflation was evaluated by arterial blood gas analysis.ResultsSignificantly fewer patients in the CO(2) group had severe pain of ≥ 50 mm on the VAS during DBE than in the air group (P = .02). Significantly less gas was retained in the small bowel just after and at 3 hours after DBE in the CO(2) group than in the air group (P = .003, P = .01, respectively). There was significantly less residual gas retention in the large bowel at 3 hours after DBE in the CO(2) group than in the air group (P = .02). There was no significant difference in pre-DBE and post-DBE partial pressure of oxygen in the blood (PaO(2)) and partial pressure of carbon dioxide in the blood (PaCO(2)) between groups.LimitationsSmall sample size.ConclusionCO(2) insufflation is a safe and useful procedure when performed during DBE.Copyright © 2011 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

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