The Clinical Research Of Safety And Efficacy Of Carbon Dioxide Insufflation During The Double Ballon Enteroscopy

Objective:in order to explor the efficacy and safety of carbon dioxide insufflation during the double ballon enteroscopy.Methods:In a radomizde,double-blinded design, Atotal of 34 consecutive patients underging double ballon enteroscopy were assigned to the use of either CO2 or AIR insufflation.End tidal CO2 (ET CO2),Heart rate(HR),arterial oxygen tidal of saturation(SPO2),systolic blood pressure(SBP),diastolic blood pressure(DBP) were recorded at the beginning, repeatedly duing the pull and push procedure,the end and 10 minuts after the examination. The patient's experience of pain at 1,3,6 and 24 hours after the examination and consciousness from sedation was registered using a visual analogue scale (VAS). Flatus passage scores (ordinal scale:1=trace, to 4=extreme) were recorded immediately at 1, 6and 24 hours after double ballon enteroscopy. Abdominal circumference were measured before and repeatedly during and after the examination. Examination times and insertion depth were also recorded. Residual small bowel and colonic gas of 20 radomizdely choosed patients was evaluated on abdominal radiographs at 1 hour. Intravenous and inhalation anesthesia with Artificial ventilation were used during the examination.Results:1. Baseline characteristics comparison of patients in two groups:There were no difference in baseline characteristics between patients in two groups,included sex,age,weight,et al.2. Comparison of VAS scores:patient pain and discomfort were significantly reduced in the CO2 group at 1,3 and 6 hours after the examination,and no difference at 24 hours after the examination.3. Comparison of PETCO2:there was a significant reduction in PETCO2 levels during examination and 10 minuts after the examination in both group, there was no statistic difference between the two group. 4. Comparison of flatus and abdominal circumference:At 1 and 6 hours after DBE the CO2 group reported significantly less passage of flatus than the air group ((P<0.05),no difference 24h afterward. Abdominal girth increased during the examination in both group,but recovery to pre-DBE lever after the examination in CO2 group,still much higher than pre-DBE lever in AIR group(p<0.001).5. Comparison of examination times and insertion depth:there were no statistic difference in examination times. The intubation depth of oral procedures,and the total intubation depth of both oral and anal procedures was increased in the CO2 group compared to the air group, no statistic difference between the two group of anal procedures.6. Comparison of radiograph scores:20 radomizdely choosed patients took a erect position abdominal radiograph, There were significant differences in the amounts of residual gas seen in both small and large bowel.7. Comparison of HR,SPO2,SBP,DBP:we observed a modest reductio-n of HR,SBP,DBP within the normal range,and a mild rise of SPO2 with-in the normal range,no statistic difference between the two group.Conclusions:Carbon dioxide insufflation during double-ballon en-teroscopy is safe and effective,not only signifcantly reduce the post-procedure discomfort,bloating and flatus,but also increase the insertion depth of DBE,and will not cause CO2 retention.