Pediatric anesthesia & critical care
Sedation and Analgesia for Reduction of Pediatric Ileocolic Intussusception
An erratum to this article was published (JAMA Netw Open, 1 May 2024 ↗)
Authors' conclusion
This cross-sectional study of pediatric ileocolic intussusception found that more than two-thirds of patients received neither analgesia nor sedation.
Study context
- Population
- Children aged 4 to 48 months with attempted reduction of ileocolic intussusception, 2017–2019
- Participants
- 3,203 children · 86 institutions
- Outcome
- Opioid analgesia within 120 minutes of reduction and sedation immediately before reduction of intussusception
Methodological detailsmulticentre, 86 pediatric tertiary care institutions in 14 countries, medical record review
- Multicentre
- 86 pediatric tertiary care institutions in 14 countries
- Medical record review
Main finding
As reported in the abstract
Prevalence of opioid analgesia and sedation
Opioid use, 395 of 3134 patients
12.6%
Sedation, 334 of 3161 patients
10.6%
Opioids plus sedation, 178 of 3134 patients
5.7%
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value | |
|---|---|---|---|
| Failed reduction, adjusted analysisYounger age · adjusted | OR 1.05 per month (95% CI 1.03–1.06) | P < 0.001 | |
| Failed reduction, adjusted analysisDuration of symptoms · adjusted; shorter duration | OR 0.96 per hour (95% CI 0.94–0.99) | P = 0.002 | |
| 0.512Odds ratio (log scale) |
Failed reduction, adjusted analysis
| OR (95% CI) | P value | ||
|---|---|---|---|
| Gastrointestinal anomalyAdjusted | 6.50 (2.04–20.64) | P = 0.002 | |
| 0.050.21520Odds ratio (log scale) |
Successful reduction
- Successful reductions, 2700 of 3184 attempts
- 84.8%
- Opioids associated with failed reduction in unadjusted analysis only; not significant after adjustment
Safety
Intestinal perforation
| OR (95% CI) | P value | ||
|---|---|---|---|
| Opioids plus sedationUnadjusted; not significant in adjusted analysis | 5.92 (1.28–27.42) | P = 0.02 | |
| Greater number of reduction attemptsUnadjusted; not significant in adjusted analysis | 1.48 (1.03–2.11) | P = 0.03 | |
| 0.050.21520Odds ratio (log scale) |
- Intestinal perforation — Perforation, 13 of 3203 patients
- 0.4%
Original publication
Sedation and Analgesia for Reduction of Pediatric Ileocolic Intussusception. JAMA Netw Open. Published 1 June 2023. doi:10.
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