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Deep sedation during pneumatic reduction of intussusception
Anat Ilivitzki1, Luda Glozman Shtark, Karin Arish
1Department of Diagnostic Imaging, Rambam Health Care Campus, Haifa, Israel. a_ilivitaki@rambam.health.gov.il
Insights
Deep sedation using propofol during pneumatic reduction for intussusception in children is safe and effective. This approach improves success rates and reduces procedure time without adding complications.
Area of Science:
- Pediatric Gastroenterology
- Medical Imaging
- Anesthesiology
Background:
- Pneumatic reduction for intussusception is standard but challenging in unsedated children.
- Patient resistance can prolong procedures and increase radiation exposure.
- Deep sedation is employed to mitigate these challenges.
Purpose of the Study:
- To evaluate the use of deep sedation during fluoroscopic reduction of intussusception.
- To assess the benefits and complication rate associated with deep sedation.
Main Methods:
- Retrospective study of children undergoing pneumatic reduction between 2004 and 2011.
- Deep sedation administered by anesthesiologists using propofol.
- Review of fluoroscopic and ultrasound studies, and patient charts.
Main Results:
- 131 reductions in 119 children; 92% success rate.
- Two perforations (1.5%) occurred.
- Average fluoroscopic time was 1.5 minutes; no sedation-related complications.
Conclusions:
- Deep sedation with propofol is safe for pneumatic reduction of intussusception.
- Short fluoroscopic times and high success rates suggest potential benefits, possibly via smooth muscle relaxation.
Background:
Pneumatic reduction of intussusception under fluoroscopic guidance is a routine procedure. The unsedated child may resist the procedure, which may lengthen its duration and increase the radiation dose. We use deep sedation during the procedure to overcome these difficulties.
Objective:
The purpose of this study was to summarize our experience with deep sedation during fluoroscopic reduction of intussusception and assess the added value and complication rate of deep sedation.
Materials And Methods:
All children with intussusception who underwent pneumatic reduction in our hospital between January 2004 and June 2011 were included in this retrospective study. Anesthetists sedated the children using propofol. The fluoroscopic studies, ultrasound (US) studies and the childrens' charts were reviewed.
Results:
One hundred thirty-one attempted reductions were performed in 119 children, of which 121 (92%) were successful and 10 (8%) failed. Two perforations (1.5%) occurred during attempted reduction. Average fluoroscopic time was 1.5 minutes. No complication to sedation was recorded.
Conclusions:
Deep sedation with propofol did not add any complication to the pneumatic reduction. The fluoroscopic time was short. The success rate of reduction was high,raising the possibility that sedation is beneficial, possibly by smooth muscle relaxation.
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