Midazolam premedication in ileocolic intussusception: a retrospective multicenter study

Area of Science:

• Pediatric Gastroenterology
• Emergency Medicine
• Surgical Procedures

Background:

• Ileocolic intussusception is a frequent cause of bowel obstruction in children.
• Non-operative management via enema reduction is standard when spontaneous reduction fails.
• The use of sedatives during enema reduction is not yet common practice despite evidence of benefit.

Purpose of the Study:

• To evaluate if midazolam (MDZ) administered before enema improves the success rate of intussusception reduction.
• To assess the impact of MDZ on recurrence rates and the need for surgical intervention.

Main Methods:

• Retrospective chart review of pediatric patients undergoing enema reduction for intussusception.
• Comparison of outcomes between patients who received MDZ and those who did not.
• Analysis of demographics, clinical characteristics, ultrasound findings, and procedural success rates.

Main Results:

• The success rate of enema reduction was significantly higher in the MDZ group (75%) compared to the non-MDZ group (32.4%) (P < .001).
• Fewer patients in the MDZ group required surgery (27.9%) versus the non-MDZ group (77.8%) (P < .001).
• Multivariate analysis confirmed MDZ as a significant positive predictor for enema success (OR 7.602, P < .001).

Conclusions:

• Procedural sedation with midazolam enhances the success rate of enema reduction for intussusception.
• MDZ administration leads to improved patient management and a reduced need for surgical intervention.
• Routine use of midazolam should be considered for enema reduction procedures in pediatric intussusception.