Insufflation (medicine)

For the ritual acts in magic or religion, see Insufflation.

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

Common misconception

Nasal inhalation of recreational drugs ("snorting") is often considered an example of insufflation, 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.

This widespread misuse of the term "nasal insufflation" to refer to "snorting" has led to a secondary colloquial definition (insufflation (recreational use) used only in the scope of recreational drug use.

Medical uses

Historical

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

Surgery

Gases are often insufflated into a body cavity to inflate the cavity for more workroom, eg. 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 or to gain access to areas for visual inspection (e.g. during colonoscopy).

Minimally-invasive procedures

Gas (usually air) can be used to reduce obstruction using minimally-invasive procedures, eg. reduction of bowel obstruction caused by intussusception.

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

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

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.