{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T19:50:43Z","timestamp":1754164243941,"version":"3.41.2"},"reference-count":29,"publisher":"Korean Pediatric Society","issue":"8","license":[{"start":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T00:00:00Z","timestamp":1741651200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["e-cep.org"],"crossmark-restriction":true},"short-container-title":["Clin Exp Pediatr"],"published-print":{"date-parts":[[2025,8,15]]},"abstract":"<jats:p>Background: Adequately powered studies in children are scarce and there are reports on the risk of carbon dioxide (CO2) retention after colonoscopy.Purpose: This study investigated the efficacy and safety of CO2 insufflation in children undergoing colonoscopy.Methods: This prospective randomized clinical trial was conducted at a tertiary care hospital between March 2023 and July 2024. We recruited 200 consecutive children (age, 5\u201318 years; n=100 in each arm) who underwent colonoscopy under conscious sedation. Patients were randomized to receive CO2 or room air using a random number table. The primary outcome measure was postprocedural pain assessed by using a visual analogue scale (VAS). Secondary outcome measures included time to reach the cecum, total procedure duration, abdominal distension, and end-tidal (ET) CO2 level. Complications were recorded.Results: Pain scores at 2 and 4 hours postprocedure were significantly lower in the CO2 versus room-air group (1.12 vs. 1.66, P=0.001 at 2 hours and 0.37 vs. 0.61, P=0.002 at 4 hours). The time to reach the cecum was significantly higher in the CO2 group (39.6 vs. 26.6 min, P=0.01). A greater proportion of children in the room-air group (29% vs. 19%, P=0.04) reported significant pain (VAS score, \u22653). The subgroup analysis revealed a significantly longer time to reach the cecum and total procedure duration in the CO2 group among first-year trainees. ET-CO2 levels were significantly higher in the CO2 group (36 [interquartile range, 35\u201337] mmHg vs. 34 [interquartile range, 32\u201335] mmHg, P=0.001), but none developed any signs of CO2 retention. No significant intergroup differences were noted in abdominal girth, bloating sensation, analgesic requirements, or procedure-related complications.Conclusions: CO2 insufflation is safer and makes the procedure less painful but slower than room-air insufflation, especially in first-year trainees, without an increased risk of retention.<\/jats:p>","DOI":"10.3345\/cep.2024.02012","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T03:58:17Z","timestamp":1741665497000},"page":"594-600","update-policy":"https:\/\/doi.org\/10.3345\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and safety of carbon dioxide versus room-air insufflation in pediatric colonoscopy: a randomized controlled trial"],"prefix":"10.3345","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-5010-7531","authenticated-orcid":true,"given":"Ajay","family":"Aravind","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5277-4401","authenticated-orcid":true,"given":"Ujjal","family":"Poddar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0902-4140","authenticated-orcid":true,"given":"Anshu","family":"Srivastava","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2015-4069","authenticated-orcid":true,"given":"Moinak","family":"Sen 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