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Comparing sedative and non-sedative reduction techniques in paediatric intussusception: Insights from a 6-year study

E Purnomo1, K Gibran2, A Makhmudi2

  • 1Universitas Gadjah Mada/Dr. Sardjito Hospital, Faculty of Medicine, Public Health and Nursing, Department of Surgery, Pediatric Surgery Division, Yogyakarta, Indonesia. eko.p@ugm.ac.id.

The Medical Journal of Malaysia
|August 31, 2024
PubMed

Insights

Sedative reduction (SR) for paediatric intussusception significantly increases successful hydrostatic reduction rates compared to non-sedative reduction (NSR). SR may reduce the need for surgery in children with intussusception.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Emergency Medicine

Background:

  • Intussusception is a common pediatric emergency requiring prompt management.
  • Standard treatment involves hydrostatic reduction, with sedation potentially optimizing outcomes.
  • Sedation-induced muscle relaxation can facilitate successful enema reduction.

Purpose of the Study:

  • To compare the efficacy of sedative reduction (SR) versus non-sedative reduction (NSR) for pediatric intussusception.
  • To evaluate the impact of sedation on the success rates of hydrostatic reduction.
  • To analyze the rates of surgical intervention following failed non-operative reduction attempts.

Main Methods:

  • A retrospective cohort study of 85 children with intussusception in Yogyakarta, Indonesia (Jan 2017 - Jul 2023).
  • Hydrostatic reduction using water-soluble contrast was performed.
  • Patients were divided into SR (ketamine and midazolam) and NSR groups.

Main Results:

  • Successful reduction was achieved in 77% of SR cases versus 38.0% of NSR cases.
  • The relative risk of successful reduction with SR was 2.02 (p < 0.05).
  • 39 children who failed NSR required surgical intervention, including anastomosis resection and stoma creation.

Conclusions:

  • Sedative reduction (SR) demonstrates a higher success rate for hydrostatic reduction in pediatric intussusception.
  • Implementing SR may decrease the rate of surgical interventions for intussusception.
  • This study contributes to understanding non-operative management strategies for pediatric intussusception.
Abstract

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