Opioid Administration and Reduction of Pediatric Ileocolic Intussusception

Area of Science:

• Pediatric Gastroenterology
• Pain Management
• Surgical Outcomes

Background:

• Ileocolic intussusception is a common cause of bowel obstruction in children, often requiring painful reduction procedures.
• Sedation and analgesia are not routinely administered due to concerns about potential gastrointestinal slowing and failed reduction.
• The association between fentanyl use and failed intussusception reduction in pediatric patients is not well-established.

Purpose of the Study:

• To investigate the association between fentanyl administration and failed reduction in children undergoing ileocolic intussusception reduction.
• To evaluate the safety and efficacy of fentanyl as an analgesic option for pediatric intussusception.

Main Methods:

• Secondary analysis of a cross-sectional study involving 86 pediatric tertiary care centers across 14 countries.
• Included 3184 children aged 4-48 months with ileocolic intussusception and attempted reduction.
• Analyzed data on fentanyl use, patient demographics, and reduction outcomes using bivariate and multivariable analyses.

Main Results:

• Fentanyl was administered to 3.66% of patients prior to reduction.
• The overall rate of failed reduction was 15.20%.
• Fentanyl use was not associated with failed reduction in both unadjusted (OR, 0.66) and adjusted analyses. Preexisting gastrointestinal anomalies, longer time to reduction, and younger age were associated with failed reduction.

Conclusions:

• Fentanyl administration prior to attempted reduction of pediatric ileocolic intussusception is not associated with failed reduction.
• These findings support the consideration of fentanyl as a safe therapeutic option for managing pain associated with intussusception reduction in children.
• Further research may explore optimal dosing and timing for fentanyl use in this population.