Carbon dioxide (CO2) insufflation has been demonstrated in studies to be superior to air insufflation during colonoscopies in adults. The purpose of this study was to look at the efficacy and safety of CO2 insufflation in profoundly sedated children having colonoscopy. This was a randomised, double-blind, prospective clinical study. Researchers enrolled 100 consecutive paediatric patients who had colonoscopy under heavy sedation for a variety of reasons. Patients were initially allocated to CO2 or air insufflation based on their history of stomach discomfort. Postprocedural abdominal pain was scored on a 10-point visual analogue rating scale, with a score of 3 or above indicating severe discomfort. End tidal CO2 (ETCO2) levels and abdominal circumferences were assessed. Complications that occurred during and after the operation were documented. On multivariable analysis, they discovered that pain was substantially reduced in patients following CO2 versus air insufflation after controlling for baseline pain. The duration of the procedure, a history of stomach discomfort, and previous abdominal surgery were all major pain variables. Following a colonoscopy, CO2 insufflation was related with a reduction in belly circumference.

The majority of youngsters undergo endoscopic treatments without experiencing severe pain. On univariate analysis, this investigation was underpowered to reveal a significant difference between air and CO2. However, CO2 insufflation during colonoscopy may decrease postprocedural stomach discomfort. On multivariate analysis, significant variables for greater discomfort were colonoscopy length of more than 30 minutes, a history of stomach pain, and recent abdominal surgery.

Reference:https://journals.lww.com/jpgn/Fulltext/2020/07000/Efficacy_and_Safety_of_Carbon_Dioxide_Versus_Air.13.aspx