Deep sedation during pneumatic reduction of intussusception

“…In a more recent period (2000-2003), a nationwide study performed in the USA reported similar results with a 39% likelihood of radiologic reduction in high-volume pediatric hospitals (2). In a recent study, Ilivitzki et al (12) report a success rate of 92% similar to our results. These authors used deep sedation with propofol.…”

Section: Discussionsupporting

confidence: 88%

General anesthesia for intussusception reduction by enema

Purenne

Franchi‐Abella

Branchereau

et al. 2012

Pediatric Anesthesia

View full text Add to dashboard Cite

show abstract

“…The primary studies underwent a critical appraisal process and 28 were excluded due to unspecified imaging modality ( n = 10), enema medium ( n = 1), number of attempts at reduction ( n = 6) and number of complications ( n = 11). Consequently, 43 studies were included, 1 SR and 42 studies relating to a single technique …”

Section: Resultsmentioning

confidence: 99%

Comparison of safety and efficacy of image‐guided enema reduction techniques for paediatric intussusception: A review of the literature

et al. 2017

View full text Add to dashboard Cite

There is variable international practice regarding the technique used for image-guided enema reduction in paediatric intussusception. A recent meta-analysis found pneumatic reduction to be more effective than hydrostatic techniques. Clinical practice variation may impact on perforation rates, ionizing radiation exposure and requirement for surgery. The aim of this study was to review the literature regarding the efficacy and safety of fluoroscopically guided pneumatic reduction (FGPR) compared to ultrasound (US) guided intussusception reduction (USGIR) techniques for paediatric intussusception treatment. Articles were identified by searching OVID Medline on 21/02/14 and by scanning retrieved articles reference lists. The search was repeated on 30/09/15. Systematic reviews (SR) were appraised with the PRISMA critical appraisal tool. Primary studies underwent a separate critical appraisal process. Successful reductions and perforations per attempt were calculated for each study. Pooled estimates of proportions were calculated for each of these dichotomous outcomes. A SR and 42 primary studies were included in the review. No randomised control trial (RCT) study was included. Non-randomised comparative studies and non-comparative studies suggest that hydrostatic reduction under US control has a similar efficacy and safety profile to pneumatic reduction under fluoroscopic control, but USGIR data are dominated by a single large, non-comparative study performed in China. US-guided intussusception reduction should be considered an alternative to FGPR as it has similar efficacy and safety, and affords no ionised radiation exposure. However, RCT data are required to inform practice.

show abstract

“…The effect of sedation on outcome is controversial: some studies reported a lower reduction rate [18], while others found a higher rate of success with sedation [31]. A recent paper reports excellent success with propofol, perhaps secondary to long-lasting bowel relaxation [32], while glucagon did not confer any benefit in two independent studies [33,34].…”

Section: Discussionmentioning

confidence: 96%