The use of glucagon in hydrostatic reduction of intussusception: a double-blind study of 30 patients.

Abstract

Thirty patients were referred for hydrostatic reduction of ileocolic intussusception. Children with suspected gangrenous bowel or sensitivity to glucagon were excluded from the investigation. A standard protocol for the procedure was used in all patients, including the intravenous administration of glucagon or placebo (0.05 mg/kg) when the intussusception was encountered. Successful reduction was achieved in 53% of both control and glucagon-treated patients. Analysis of the length of the procedure and the ease of reduction of the intussusception indicated no difference in the two groups. This multicenter double-blind study failed to show any therapeutic value of glucagon in hydrostatic reduction of intussusception.

Japanese guidelines for the management of intussusception in children, 2011

“…Glucagon has muscle relaxant effects as well as Buscopan, and has been used for enema reduction. In earlier reports, the reduction rate was higher when Glucagon was used 80,82 (level 3b); however, more recent randomized controlled studies have shown that glucagon is of no benefit 84,85 (level 2b). The use of glucagon is not recommended as it is an expensive drug in comparison to Buscopan, and health insurance in Japan may not cover the fee.…”

Current methods for reducing intussusception: survey results

“…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].…”

Delayed Repeated Enema and Operative Findings after Unsuccessful Primary Enema for Intussusception

“…Our institution does not use sedation during enema reduction attempts; however, the literature lacks conclusive data about the efficacy of sedation in aiding attempts at enema reduction. 6,[13][14][15][16] There was a 14.1% referral rate (n ¼ 19) for our intussusception patients, for which patients initially diagnosed at a referring institution were transferred to our hospital for definitive care. These transfers from the community predispose these patients to a longer duration of symptoms and delay in intervention which may affect success of a primary reduction, although data are inconsistent in determining if longer duration of symptoms affects the rate of successful enema reduction.…”