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Surgical Endoscopy

Erschienen in:

01.07.2010

Safety of carbon dioxide insufflation for upper gastrointestinal tract endoscopic treatment of patients under deep sedation

verfasst von: Satoru Nonaka, Yutaka Saito, Hajime Takisawa, Yongmin Kim, Tsuyoshi Kikuchi, Ichiro Oda

Erschienen in: Surgical Endoscopy | Ausgabe 7/2010

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Abstract

Background

It is well known that carbon dioxide (CO₂) is absorbed faster in the body than air and also that it is rapidly excreted through respiration. This study aimed to investigate the safety of CO₂ insufflation used for esophageal and gastric endoscopic submucosal dissection (ESD) in patients under deep sedation.

Methods

Patients with either early gastric or esophageal cancers that could be resected by ESD were enrolled in this study from March 2007 to July 2008 and randomly assigned to undergo ESD procedures with CO₂ insufflation (CO₂ group) or air insufflation (air group). A TOSCA measurement system and TOSCA 500 monitor were used to measure and monitor both transcutaneous partial pressure of CO₂ (PtcCO₂) and oxygen saturation (SpO₂).

Results

The study enrolled 89 patients and randomly assigned them to a CO₂ group (45 patients) or an air group (44 patients). The mean CO₂ group versus air group measurements were as follows: PtcCO₂ (49.1 ± 5.0 vs. 50.1 ± 5.3 mmHg; nonsignificant difference [NS]), maximum PtcCO₂ (55.1 ± 6.5 vs. 56.8 ± 7.0 mmHg; NS), PtcCO₂ elevation (9.1 ± 5.4 vs. 11.4 ± 5.6 mmHg; p = 0.054), SpO₂ (99.0 ± 0.7% vs. 99.0 ± 1.0%; NS), minimum SpO₂ (96.5 ± 2.4% vs. 95.4 ± 3.3%; p = 0.085), and SpO₂ depression (2.4 ± 2.3% vs. 3.3 ± 2.9%; NS). The PtcCO₂ and SpO₂ measurements were similar in the two groups, but the CO₂ group was better than the air group in PtcCO₂ elevation and minimum SpO₂.

Conclusions

The findings demonstrated CO₂ insufflation to be as safe as air insufflation for upper gastrointestinal tract ESDs performed for patients under deep sedation without evidencing any adverse effects.

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Titel: Safety of carbon dioxide insufflation for upper gastrointestinal tract endoscopic treatment of patients under deep sedation
verfasst von: Satoru Nonaka
Yutaka Saito
Hajime Takisawa
Yongmin Kim
Tsuyoshi Kikuchi
Ichiro Oda
Publikationsdatum: 01.07.2010
Verlag: Springer-Verlag
Erschienen in: Surgical Endoscopy / Ausgabe 7/2010
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-009-0824-5

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Abstract

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