Insufflation (medicine)

Insufflation (Latin: insufflare, lit. 'to blow into') is the act of blowing something (such as a gas, powder, or vapor) into a body cavity.[1] Insufflation has many medical uses, most notably as a route of administration for various drugs.

Recreational drugs

Nasal inhalation of recreational drugs ("snorting") is often considered an example of insufflation,[2][3][4][5] though the etymology and scientific understanding of the term does not include inhalation of any kind, as blowing requires the application of positive pressure to push the substance into the nose, whereas inhaling refers to drawing or sucking in, which requires the generation of negative pressure in the thorax.

Medical uses

Surgery

Gases are often insufflated into a body cavity to inflate the cavity for more workroom, e.g. during laparoscopic surgery. The most common gas used in this manner is carbon dioxide, because it is non-flammable, colorless and dissolves readily in blood. It is, however, not an inert gas.

Diagnostics

Gases can be insufflated into parts of the body to enhance radiological imaging[6] or to gain access to areas for visual inspection (e.g. during colonoscopy).[7]

Respiratory assistance

Oxygen can be insufflated into the nose by nasal cannulae to assist in respiration.

Pump inhalers for asthmatics deliver aerosolized drugs into the lungs via the mouth. However, the insufflation by the pump is not adequate for delivery to the lungs, necessitating an active inhalation by the patient.

Anesthesia and critical care

Insufflated gases and vapors are used to ventilate and oxygenate patients (oxygen, air, helium), and to induce, assist in or maintain general anaesthesia (nitrous oxide, xenon, volatile anesthetic agents).

Nasal drug administration

Cocaine is a drug that is commonly taken into the body via nasal inhalation

Nasal insufflation is the most common method of nasal administration. Other methods are nasal inhalation (common in recreational use) and nasal instillation. Drugs administered in this way can have a local effect or a systemic effect. The time of onset for systemic drugs delivered via nasal administration is generally only marginally slower than if given intravenously. The bioavailability of drugs administered nasally is generally significantly higher than drugs taken orally.

Examples of drugs given

  • Steroids (local effect) and anti-asthma medication
  • Hormone replacement
  • Decongestants (local effect)
  • Nicotine replacement
  • Migraine medication
  • Vaccines
  • ADHD medications such as methylphenidate

Nasal administration can also be used for treatment of children or patients who are otherwise alarmed or frightened by needles, or where intravenous (IV) access is unavailable.

Alternative medicine

As an alternative medicine treatment, ozone therapy is claimed to increase the amount of oxygen in the body through rectal and vaginal insufflation.

History

In the 18th century, the tobacco smoke enema, an insufflation of tobacco smoke into the rectum, was a common method of reviving drowning victims.[8]

References

  1. ↑ http://www.merriam-webster.com/medical/insufflation%5Bfull+citation+needed%5D
  2. ↑ "Snorting - insufflation tips - Drugs Forum". drugs-forum.com. Retrieved 2016-03-25.
  3. ↑ "Ways of Taking Drugs". Alcohol Rehab. Retrieved 2016-03-25.
  4. ↑ "Insufflation - Taimapedia". taimapedia.org. Retrieved 2016-03-25.
  5. ↑ "Reducing risk wiki articles". www.bluebelly.org.au. Retrieved 2016-03-25.
  6. ↑ Sloane, P M; Griffin, J F; O'Dwyer, T P; Griffin, J M (1991). "Esophageal insufflation and videofluoroscopy for evaluation of esophageal speech in laryngectomy patients: Clinical implications". Radiology. 181 (2): 433–7. doi:10.1148/radiology.181.2.1924785. PMID 1924785.
  7. ↑ Ramaraj, R; Sugumaran, A; Khan, H; Mathialahan, T; George, P (2011). "Comparison of carbon dioxide (CO2) to air insufflation in colonoscopy". Gut. 60: A200. doi:10.1136/gut.2011.239301.421.
  8. ↑ Lawrence, Ghislaine (2002). "Tobacco smoke enemas". The Lancet. 359 (9315): 1442. doi:10.1016/S0140-6736(02)08339-3.
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