Objective To investigate and compare the effects of injecting air or carbon dioxide(CO2) in patients undergoing routine colonoscopy after gynecological surgery. Methods Sixty-two patients undergoing painless colonoscopy after gynecological surgery were divided into CO2 group and air group by random number table method with 31 patients in each group, CO2 and air were injected to patients, respectively. The success rate of colonoscopy, procedure time, dose of propofol, recovery time and the degree of abdominal pain at different time after colonoscopy were recorded. The changes of HR, MAP, SpO2 and transcutaneous carbon dioxide partial pressure(PtcCO2) before and after the procedure were measured and compared at the same time point. Each patient rated, using VAS, the intensity of abdominal pain at 15 min, 1 h, 3 h, 6 h and 24 h after colonoscopy. Results There was no difference in the success rate of examination, procedure time, dose of propofol and recovery time between the two groups(P>0.05). Furthermore, there was no difference in HR, MAP, SpO2 and PtcCO2 between the two groups before, during and after the examination, respectively(P>0.05). However, at 15 min, 1 h, 3 h, 6 h, 24 h after examination, the VAS scores of patients in the CO2 group were significantly lower than that of the air group with the data of [(21.6±9.5) vs (46.7±14.1), (14.4±5.4) vs (32.6±9.6), (9.1±3.6) vs (22.9±8.4), (4.3±1.1) vs (9.7±3.5), (2.3±1.1) vs(4.1±1.9)](P<0.05), respectively. Conclusions CO2 is safe and effective in patients undergoing routine painless colonoscopy after gynecological surgery, moreover, it can reduce the degree of abdominal pain after the examination. Key words: Colonoscopy; Carbon dioxide; Gynecological surgery; Abdominal pain

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