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首页> 外文期刊>Endoscopy International Open >Carbon dioxide versus room air insufflation during balloon-assisted enteroscopy: A systematic review with meta-analysis
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Carbon dioxide versus room air insufflation during balloon-assisted enteroscopy: A systematic review with meta-analysis

机译：气囊辅助肠镜检查中二氧化碳与室内空气注入的关系：荟萃分析的系统综述

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Background and study aims?Carbon dioxide (CO2) insufflation has been suggested to be an ideal alternative to room air insufflation to reduce trapped air within the bowel lumen after balloon assisted enteroscopy (BAE). We performed a systematic review and meta-analysis to assess the safety and efficacy of utilizing CO2 insufflation as compared to room air during BAE. Patients and methods?The primary outcome is mean change in visual analog scale (VAS; 10?cm) at 1, 3, and 6 hours to assess pain. Secondary outcomes include insertion depth (anterograde or retrograde), adverse events, total enteroscopy rate, diagnostic yield, mean anesthetic dosage, and PaCO2 at procedure completion. We searched MEDLINE and the Cochrane Central Register of Controlled Trials (CENTRAL) from inception until May 2015.?Multiple independent extractions were performed, the process was executed as per the standards of the Cochrane collaboration. Results?Four randomized controlled trials (RCTs) were included in the meta-analysis. VAS at 6 hours favored CO2 over room air (MD 0.13; 95?% CI 0.01, 0.25; p?=?0.03). Anterograde insertion depth (cm) was improved in the CO2 group (MD, 58.2; 95?% CI 17.17, 99.23; p?=?0.005), with an improvement in total enteroscopy rate in the CO2 group (RR 1.91; 95?% CI 1.20, 3.06; p?=?0.007). Mean dose of propofol (mg) favored CO2 compared to air (MD,?–?70.53; 95?% CI?–?115.07,?–?25.98; P?=?0.002). There were no differences in adverse events in either group. Conclusions?Despite the ability of CO2 to improve insertion depth and decrease amount of anesthesia required, further randomized control trials are needed to determine the agent of choice for insufflation in balloon assisted enteroscopy.
机译：背景和研究目标？二氧化碳（CO2）吹入法被认为是室内空气吹入法的理想替代方法，以减少气囊辅助肠镜检查（BAE）后肠腔内的滞留空气。我们进行了系统的回顾和荟萃分析，以评估与BAE期间的室内空气相比，使用CO2吹入的安全性和有效性。患者和方法：主要结果是在1、3和6小时评估疼痛的视觉模拟量表（VAS; 10？cm）的平均变化。次要结果包括插入深度（顺行或逆行），不良事件，总肠镜检查率，诊断率，平均麻醉剂量和手术完成时的PaCO2。从开始到2015年5月，我们搜索了MEDLINE和Cochrane对照试验中央注册系统（CENTRAL）。进行了多次独立提取，并按照Cochrane合作标准执行了该过程。结果：荟萃分析包括四项随机对照试验（RCT）。 6小时后的VAS较室内空气更有利于CO2（MD 0.13; 95％CI CI 0.01，0.25; p == 0.03）。 CO2组的顺行插入深度（cm）有所改善（MD，58.2; 95％CI 17.17，99.23; p？=？0.005），CO2组的总肠镜检查率有所改善（RR 1.91; 95％ CI 1.20，3.06;p≤0.007）。与空气相比，丙泊酚的平均剂量（mg）更有利于二氧化碳（MD，η-？70.53; 95％CI？-？115.07，？-？25.98; P？=？0.002）。两组的不良事件均无差异。结论尽管CO2具有改善插入深度和减少所需麻醉量的能力，但仍需要进一步的随机对照试验来确定气囊辅助肠镜检查中吹入药剂的选择。

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