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Sedative reduction method for children with intussusception.

Jin Woong Doo1, Soon Chul Kim

  • 1Department of Pediatrics, Chonbuk National University Medical School and Hospital, Research Institute of Clinical Medicine of Chonbuk National University - Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, South Korea.

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|February 1, 2020
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Summary
This summary is machine-generated.

Sedative reduction (SR) using ketamine, midazolam, and atropine can improve success rates for pediatric intussusception, potentially reducing the need for surgery after initial hydrostatic reduction (HR) failures.

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Area of Science:

  • Pediatric Gastroenterology
  • Interventional Radiology
  • Pediatric Surgery

Background:

  • Intussusception is a common pediatric emergency.
  • Hydrostatic reduction (HR) is the primary non-surgical treatment, but repeated failures may necessitate surgery.
  • Sedatives are typically avoided in pediatric interventional radiology.

Purpose of the Study:

  • To evaluate the efficacy of sedative reduction (SR) during the third attempt of hydrostatic reduction for pediatric intussusception.
  • To determine if SR can decrease the rate of surgical intervention in refractory cases.

Main Methods:

  • SR was performed using intravenous ketamine, midazolam, and atropine.
  • Patients with contraindications for HR underwent laparoscopic reduction (LR).
  • Data collected over 3 years from 43 patients undergoing SR.

Main Results:

  • Successful reduction was achieved in 65.1% (28/43) of patients undergoing SR.
  • Of the 15 patients with failed SR, 14 proceeded to LR without intestinal resection.
  • No significant risk factors for failed SR were identified.

Conclusions:

  • Sedative reduction (SR) with ketamine, midazolam, and atropine is effective for pediatric intussusception, particularly on the second or third hydrostatic reduction (HR) attempt.
  • SR may significantly reduce the overall rate of surgical intervention for intussusception in children.