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

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.