Background and study aims: A new colonoscope (XCFQ-160AW prototype, Olympus, Tokyo, Japan) has been developed, designed with an additional passive bending function to ease intubation through the left colonic flexure. ...Background and study aims: A new colonoscope (XCFQ-160AW prototype, Olympus, Tokyo, Japan) has been developed, designed with an additional passive bending function to ease intubation through the left colonic flexure. In this study we investigated whether this function could be included in a standard colonoscope without jeopardizing general performance, particularly passage through the sigmoid colon. Patients and methods: 280 outpatients referred for routine colonoscopy at Telemark Hospital were randomly allocated to colonoscopy with a standard colonoscope (Olympus 140 series) or the XCFQ160AW prototype. Sedation was given on demand. End points were cecal intubation and the patients’grading of pain in a questionnaire. Results: Cecal intubation rates were 85 %and 87 %for standard and prototype endoscopes, respectively (P=0.57). On-demand sedation was given to nine (7%) and 15 (11%) of the patients, respectively (P=0.17). Of the patients, 256 (85%) returned their questionnaire,with 87 (63%) in the standard group and 109 (77%) in the prototype group reporting that they had experienced ‘no pain/slight pain’(P < 0.001). In a multiple logistic regression analysis, this difference in experienced pain remained statistically significant after adjustment for interendoscopist variation and the use of the endoscope-stiffening function. Two patients in the study, in whom there had previously been several unsuccessful attempts at negotiating the splenic flexure, were successfully examined with the prototype colonoscope. Conclusion: Examination with the Olympus XCF-Q160AW prototype with a passive bending function caused less pain than use of a standard Olympus 140 series colonoscope, without compromising other endoscope functions for colonic intubation.展开更多
Background and study aims: Several studies have shown that insufflation of carbon dioxide (CO2) instead of air dur-ing colonoscopy can reduce postprocedural pain. However, CO2 insufflation might also lead to CO2 reten...Background and study aims: Several studies have shown that insufflation of carbon dioxide (CO2) instead of air dur-ing colonoscopy can reduce postprocedural pain. However, CO2 insufflation might also lead to CO2 retention in the human body. It was recently shown that this side effect does not occur in unsedated patients, but that sedation leads to impaired respiration. Sedated patients may therefore be more prone to CO2 retention. This randomized, double-blinded study was designed to investigate whether CO2 insufflation leads to CO2 retention in sedated patients. Patients and methods: A total of 103 consecutive patients undergoing colonoscopy were randomly assigned to the use of either CO2 or air insufflation. End-tidal carbon dioxide (ETCO2), a noninvasive parameter for arterial PCO2, was recorded before the examination, twice during it, and 10 min after it. Midazolam or pethidine, or both, were used for sedation. The patient’s pain during the examination and 1, 3, 6, and 24 h afterwards was registered using a questionnaire. Results: CO2 was used in 52 patients and air insufflation in 51. A total of 52 patients (51% ) received sedation. There were no differences in ETCO2 between the CO2 and air group. A slight increase in ETCO2 was observed in sedated patients, while there was no increase in unsedated patients. CO2 insufflation significantly reduced pain after the procedure at all time points. Conclusions: This study indicates that CO2 insufflation reduces pain and is safe to use in colonoscopy for sedated patients.展开更多
文摘Background and study aims: A new colonoscope (XCFQ-160AW prototype, Olympus, Tokyo, Japan) has been developed, designed with an additional passive bending function to ease intubation through the left colonic flexure. In this study we investigated whether this function could be included in a standard colonoscope without jeopardizing general performance, particularly passage through the sigmoid colon. Patients and methods: 280 outpatients referred for routine colonoscopy at Telemark Hospital were randomly allocated to colonoscopy with a standard colonoscope (Olympus 140 series) or the XCFQ160AW prototype. Sedation was given on demand. End points were cecal intubation and the patients’grading of pain in a questionnaire. Results: Cecal intubation rates were 85 %and 87 %for standard and prototype endoscopes, respectively (P=0.57). On-demand sedation was given to nine (7%) and 15 (11%) of the patients, respectively (P=0.17). Of the patients, 256 (85%) returned their questionnaire,with 87 (63%) in the standard group and 109 (77%) in the prototype group reporting that they had experienced ‘no pain/slight pain’(P < 0.001). In a multiple logistic regression analysis, this difference in experienced pain remained statistically significant after adjustment for interendoscopist variation and the use of the endoscope-stiffening function. Two patients in the study, in whom there had previously been several unsuccessful attempts at negotiating the splenic flexure, were successfully examined with the prototype colonoscope. Conclusion: Examination with the Olympus XCF-Q160AW prototype with a passive bending function caused less pain than use of a standard Olympus 140 series colonoscope, without compromising other endoscope functions for colonic intubation.
文摘Background and study aims: Several studies have shown that insufflation of carbon dioxide (CO2) instead of air dur-ing colonoscopy can reduce postprocedural pain. However, CO2 insufflation might also lead to CO2 retention in the human body. It was recently shown that this side effect does not occur in unsedated patients, but that sedation leads to impaired respiration. Sedated patients may therefore be more prone to CO2 retention. This randomized, double-blinded study was designed to investigate whether CO2 insufflation leads to CO2 retention in sedated patients. Patients and methods: A total of 103 consecutive patients undergoing colonoscopy were randomly assigned to the use of either CO2 or air insufflation. End-tidal carbon dioxide (ETCO2), a noninvasive parameter for arterial PCO2, was recorded before the examination, twice during it, and 10 min after it. Midazolam or pethidine, or both, were used for sedation. The patient’s pain during the examination and 1, 3, 6, and 24 h afterwards was registered using a questionnaire. Results: CO2 was used in 52 patients and air insufflation in 51. A total of 52 patients (51% ) received sedation. There were no differences in ETCO2 between the CO2 and air group. A slight increase in ETCO2 was observed in sedated patients, while there was no increase in unsedated patients. CO2 insufflation significantly reduced pain after the procedure at all time points. Conclusions: This study indicates that CO2 insufflation reduces pain and is safe to use in colonoscopy for sedated patients.
