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Effects of esketamine sedation compared to morphine analgesia on hydrostatic reduction of intussusception: A

Jascha A van de Bunt1, Esther S Veldhoen2, Rutger A J Nievelstein3

  • 1Department of Pediatric Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands.

Paediatric Anaesthesia
|September 24, 2017
PubMed

Insights

Procedural sedation with esketamine offers a potentially safer and more effective alternative to morphine analgesia for hydrostatic reduction of intussusception in children. Esketamine demonstrated a higher success rate and shorter procedure times, with no serious adverse events reported.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Anesthesiology

Background:

  • Intussusception reduction via hydrostatic or pneumatic methods can be challenging due to child resistance and pain.
  • General anesthesia improves success rates but carries risks and requires specialized personnel.
  • Procedural sedation with esketamine presents a potential alternative to mitigate these challenges.

Purpose of the Study:

  • To compare the efficacy and safety of hydrostatic reduction using esketamine procedural sedation versus morphine analgesia.
  • Key outcomes include success rate, adverse events, and duration of the reduction procedure.

Main Methods:

  • A retrospective case-cohort study compared two groups undergoing hydrostatic reduction for ileocolic intussusception.
  • Group 1 received intravenous morphine analgesia (n=37).
  • Group 2 received esketamine procedural sedation (n=20), implemented after July 2013. Cases were matched for age and symptom duration.

Main Results:

  • Esketamine sedation showed a higher success rate (90%) compared to morphine analgesia (70%).
  • Reduction time was significantly shorter with esketamine (Median 5 min) versus morphine (Median 8 min).
  • No serious adverse events were reported in either group; median hospital stay was also shorter with esketamine.

Conclusions:

  • Esketamine procedural sedation appears to be a safe alternative for hydrostatic intussusception reduction.
  • Evidence suggests esketamine may lead to higher success rates, lower recurrence, and shorter procedure and hospital stay durations compared to morphine analgesia.
Abstract

Keywords:
analgesiachildconscious sedationdissociative anestheticsintussusceptionketamine

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