Water Infusion Versus Air Insufflation During The Insertion Phase Of Unsedated Colonoscopy: A Single-center Single-blinded Randomized Controlled Trial

Objective To assess whether warm water infusion instead of air insufflation duringthe insertion phase of unsedated colonoscopy could improve patient tolerance andsatisfaction.Methods In a single-center, prospective, single-blinded randomized trial, a total of180patients were randomly assigned to three groups(water infusion group, airinsufflation group, or hybrid method group) during the insertion phase of colonoscopy.Main outcome measurements included insertion time, cecal intubation rate, adenomadetection rate, the rate of position change, the rate of abdominal compression,intraoperative pain and distension VAS scores, postoperative pain and distension VASscores.Results A total of180cases were enrolled,60each group. Compared with airinsufflation group, water infusion group and hybrid method group had less patientsrequiring abdominal compression(80%,1.67%,0%, respectively) or position change(12%,1.67%,0%, respectively), longer insertion time(7min,11min,11min, respectively), lowerintraoperative pain(4,1,1, respectively) and distension(4,1,1, respectively) VAS scoresduring the insertion phase of colonoscopy. There were no significant difference in caecalintubation rate, adenoma detection rate and postoperative pain and distension VASscores.Conclusion Water infusion significantly decreases patient abdominal pain and distensionduring the insertion phase of colonoscopy without affecting adenoma detection rate andintubation success rate.