Effectiveness of Intraluminal Air Decompression on Postcolonoscopic Pain According to Reinsertion Site
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Background: Colonoscopy is a very effective and essential examination to diagnose colorectal cancer; however,many patients experience discomfort due to post-examination abdominal pain, which reduces colonoscopy compliance. This study was conducted to determine methods for reducing post-colonoscopic abdominal pain. Methods: We conducted a randomized controlled study of 405 male and female adults who visited Hana GeneralHospital in Cheongju. We surveyed general characteristics, history of colonoscopy, and other related factors, thencategorized examinees into 5 groups (0–5) according to the site of scope reinsertion. Pain was measured using anumeric rating scale (NRS). Results: The mean age of examinees in this study was 47.8 years, and 210 participants had prior experience of colonoscopy. No significant difference was observed between variables, with the exception of reinsertion duration(P=0.005). Pain scores were different between performing physicians (P=0.006), and were higher when the subjectivelevel of procedure difficulty was low (P=0.026) in univariate analysis. Pain scores decreased as the reinsertionsite became closer to the proximal colon (P<0.001), but there was no significant difference between groups 3 and 4. The results of multiple logistic regression analysis, including univariate analysis, showed that group 1 had 0.48times, group 2 had 0.38 times, group 3 had 0.09 times, and group 4 had 0.03 times odds ratio (moderate-to-severepain, NRS ≥4) than control group 0. Conclusion: Air decompression by scope reinsertion is an effective way to reduce abdominal pain after colonoscopy. Removing air when the reinserted scope approaches the hepatic flexure seems to be the most effective methodto reduce post-colonoscopic pain.
Abstract
Background: Colonoscopy is a very effective and essential examination to diagnose colorectal cancer; however,many patients experience discomfort due to post-examination abdominal pain, which reduces colonoscopy compliance. This study was conducted to determine methods for reducing post-colonoscopic abdominal pain. Methods: We conducted a randomized controlled study of 405 male and female adults who visited Hana GeneralHospital in Cheongju. We surveyed general characteristics, history of colonoscopy, and other related factors, thencategorized examinees into 5 groups (0–5) according to the site of scope reinsertion. Pain was measured using anumeric rating scale (NRS). Results: The mean age of examinees in this study was 47.8 years, and 210 participants had prior experience of colonoscopy. No significant difference was observed between variables, with the exception of reinsertion duration(P=0.005). Pain scores were different between performing physicians (P=0.006), and were higher when the subjectivelevel of procedure difficulty was low (P=0.026) in univariate analysis. Pain scores decreased as the reinsertionsite became closer to the proximal colon (P<0.001), but there was no significant difference between groups 3 and 4. The results of multiple logistic regression analysis, including univariate analysis, showed that group 1 had 0.48times, group 2 had 0.38 times, group 3 had 0.09 times, and group 4 had 0.03 times odds ratio (moderate-to-severepain, NRS ≥4) than control group 0. Conclusion: Air decompression by scope reinsertion is an effective way to reduce abdominal pain after colonoscopy. Removing air when the reinserted scope approaches the hepatic flexure seems to be the most effective methodto reduce post-colonoscopic pain.
참고문헌 (25)
- National Cancer Center, "Cancer statistics", National Cancer Center, ~ (2013)
- National Cancer Center, "Cancer statistics", National Cancer Center, ~ (2012)
- 박상민, "대장암 선별검사의 비용 - 효과분석", Korean Journal of Family Medicine, 25(4), pp.297~306 (2004), 대한가정의학회
- 신정임, "Results of Colorectal Cancer Screening of the National Cancer Screening Program in Korea, 2008", Cancer Research and Treatment, 42(4), pp.191~198 (2010), 대한암학회
- Health Quality Ontario, "Screening methods for early detection of colorectal cancers and polyps: summary of evidence-based analyses", Ont Health Technol Assess Ser, 9, pp.1~65 (2009)
- Zauber AG, "Colonoscopic polypectomy and longterm prevention of colorectal-cancer deaths", N Engl J Med, 366, pp.687~696 (2012)
- Yang HK, "Makyeonhan duryeum, daejangnaesikyeng gumsa", Healthchosun, ~ (2015)
- Bae JY, "Deajangnaesikyeng gipihaneun eu algoboni", HealthKorea News, ~ (2011)
- Lee YC, "Factors determining post-colonoscopy abdominal pain: prospective study of screening colonoscopy in 1000 subjects", J Gastroenterol Hepatol, 21, pp.1575~1580 (2006)
- Sumanac K, "Minimizing postcolonoscopy abdominal pain by using CO(2) insufflation:a prospective, randomized, double blind, controlled trial evaluating a new commercially available CO(2) delivery system", Gastrointest Endosc, 56, pp.190~194 (2002)
- Yamano HO, "Carbon dioxide insufflation for colonoscopy: evaluation of gas volume, abdominal pain, examination time and transcutaneous partial CO2 pressure", J Gastroenterol, 45, pp.1235~1240 (2010)
- Hsu WF, "Carbon dioxide insufflation can significantly reduce toilet use after colonoscopy:a double-blind randomized controlled trial", Endoscopy, 46, pp.190~195 (2014)
- Sajid MS, "Carbon dioxide insufflation vs conventional air insufflation for colonoscopy: a systematic review and meta-analysis of published randomized controlled trials", Colorectal Dis, 17, pp.111~123 (2015)
- Lee JG, "A randomized controlled trial of total colonic decompression after colonoscopy to improve patient comfort", Am J Gastroenterol, 96, pp.95~100 (2001)
- Kim JK, "Effectiveness of a rectal tube for relief of pain after colonoscopy", Korean J Gastrointest Endosc, 19, pp.41~45 (1999)
- Steinberg EN, "Randomized controlled trial of rectal tube placement for the management of abdominal distension following colonoscopy", Gastrointest Endosc, 46, pp.444~446 (1997)
- Jenkins HH, "Correlating an 11-point verbal numeric rating scale to a 4-point verbal rating scale in the measurement of pruritus", J Perianesth Nurs, 24, pp.152~155 (2009)
- Ferreira-Valente MA, "Validity of four pain intensity rating scales", Pain, 152, pp.2399~2404 (2011)
- Wong DL, "Pain in children: comparison of assessment scales", Okla Nurse, 33, pp.8~ (1988)
- Hawker GA, "Measures of adult pain:Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP)", Arthritis Care Res (Hoboken), 63(Suppl 11), pp.S240~S252 (2011)
- Stevenson GW, "Pain following colonoscopy: elimination with carbon dioxide", Gastrointest Endosc, 38, pp.564~567 (1992)
- Andrews PL, "Vagal afferent innervation of the gastrointestinal tract", Prog Brain Res, 67, pp.65~86 (1986)
- Grundy D, "Speculations on the structure", function relationship for vagal and splanchnic afferent endings supplying the gastrointestinal tract, 1988, pp.22, 175~180
- Parkman HP, "Direct and indirect mechanosensory pathways from the colon to the inferior mesenteric ganglion", Am J Physiol, 265(3 Pt 1), pp.G499~G505 (1993)
- Ma RC, "Modulation by opioid peptides of mechanosensory pathways supplying the guinea-pig inferior mesenteric ganglion", J Physiol, 491(Pt 2), pp.435~445 (1996)