Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society
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Randomized Controlled Trial Comparative Study
Efficacy of carbon dioxide versus air insufflation according to different sedation protocols during therapeutic endoscopic retrograde cholangiopancreatography: prospective, randomized, double-blind study.
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. ⋯ 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.
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Recently, the need for sedation in gastrointestinal endoscopy has been increasing. However, the National Health Insurance Drug Price list in Japan does not include any drug specifically used for the sedation. Although benzodiazepines are the main medication, their use in cases of gastrointestinal endoscopy has not been approved. ⋯ The present guidelines comprise 14 statements, five of which were judged to be valid on the highest evidence level and three on the second highest level. The guidelines are not intended to strongly recommend the use of sedation for gastrointestinal endoscopy, but rather to indicate the policy as to the choice of appropriate procedures when such sedation is deemed necessary. In clinical practice, the final decision as to the use of sedation should be made by physicians considering patient willingness and physical condition.