Carbon dioxide insufflation during endoscopic resection of large colorectal polyps can reduce post‐procedure abdominal pain: A prospective, double‐blind, randomized controlled trial

Background Studies of the use of CO2 insufflation during endoscopic resection of large colorectal polyps (LCPs) are lacking. Objective We evaluated the effect of CO2 insufflation on pain after endoscopic resection of LCPs. Methods In a prospective randomized controlled trial (RCT), 132 patients were randomly assigned to groups who underwent endoscopic resection with CO2 insufflation (CO2 group, n = 66) or air insufflation (air group, n = 66). The primary outcome was abdominal pain post‐procedure (PP). The secondary outcomes were abdominal distension, rates of technical success, amounts of sedatives prescribed, use of analgesics, and adverse events. Results Baseline patient characteristics were similar between the groups. The mean abdominal pain score was 12.3 in the CO2 group vs. 17.5 in the air group at 1 h PP (p = 0.047). Also, the proportion of patients without pain was significantly higher in the CO2 group at 1 h PP (p = 0.008). The pain score differed more in the endoscopic submucosal dissection group and long‐time group. The secondary outcomes were not significantly different between the two groups. Conclusions The results of this RCT demonstrate the superiority of CO2 insufflation for endoscopic resection of LCPs in terms of decreasing PP abdominal pain (KCT0001636).