Related Experiment Video
Updated: Jan 6, 2026
Postoperative Ileus Murine Model
Published on: July 12, 2024
Opioid Administration and Reduction of Pediatric Ileocolic Intussusception
Karina Burke1, Itai Shavit2, Daniel M Cohen3
1Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
Insights
Fentanyl administration before intussusception reduction in children was not linked to failed reduction. This suggests fentanyl is a safe option for managing pain during pediatric intussusception treatment.
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.
Importance:
Ileocolic intussusception is an important and painful cause of bowel obstruction in children. Its reduction is also painful, but neither sedation nor analgesia is routinely provided, in part due to concerns surrounding gastrointestinal slowing and consequent failed reduction, and while fentanyl is a potent analgesic, little is known about its association with failed reduction.
Objective:
To investigate whether fentanyl is associated with failed reduction in children with intussusception.
Design, Setting, And Participants:
This was a secondary analysis of a cross-sectional study from 86 pediatric tertiary care centers in 14 countries conducted between January 1, 2017, and December 31, 2019, characterizing the association of opioid analgesia and sedation with intestinal perforation and failed reduction in children. A consecutive sample of patients 4 to 48 months of age with a discharge diagnosis of ileocolic intussusception who underwent an attempted reduction of intussusception was analyzed, excluding repeat presentations of intussusception and records lacking data for the primary outcome.
Main Outcome And Measures:
Age, sex, preexisting gastrointestinal anomalies, time to reduction, and use of prereduction opioid medication data were collected. The primary outcome was the percentage of patients with failed reduction of ileocolic intussusception. Bivariate and multivariable analyses were conducted to determine the association between fentanyl and failed reduction. Data were analyzed in February 2025.
Results:
In total, 3184 patients (2038 [64.01%] male), with a median (IQR) age of 17 (9-27) months, were included. Fentanyl was administered within 120 minutes of attempted reduction for 116 of 3167 patients (3.66%). Failed reduction occurred in 484 of 3184 patients (15.20%). In the unadjusted analysis, fentanyl was not associated with failed reduction (odds ratio [OR], 0.66 [95% CI, 0.36-1.22]). In the adjusted analysis, preexisting gastrointestinal anomalies (OR, 4.38 [95% CI, 1.50-12.76]), longer triage to reduction time (OR, 1.04 [95% CI, 1.01-1.07]), and younger age (OR, 0.96 [95% CI, 0.95-0.97]) were associated with failed reduction.
Conclusions And Relevance:
In this cross-sectional study of pediatric ileocolic intussusception, fentanyl administration prior to attempted reduction was not associated with failed reduction. These results suggest that fentanyl may be considered a safe therapeutic option to manage children's intussusception and subsequent reduction-related pain.
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