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General anesthesia for intussusception reduction by enema

Authors

  • Emilien Purenne,

    1. Départements d'Anesthésie-Réanimation, Hôpitaux Universitaires Paris-Sud, Assistance Publique – Hôpitaux de Paris, Paris, France
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  • Stéphanie Franchi-Abella,

    1. Radiologie Pédiatrique, Hôpitaux Universitaires Paris-Sud, Assistance Publique – Hôpitaux de Paris, Paris, France
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  • Sophie Branchereau,

    1. Chirurgie Pediatrique, Hôpitaux Universitaires Paris-Sud, Assistance Publique – Hôpitaux de Paris, Paris, France
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  • Catherine Baujard,

    1. Départements d'Anesthésie-Réanimation, Hôpitaux Universitaires Paris-Sud, Assistance Publique – Hôpitaux de Paris, Paris, France
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  • Dan Benhamou,

    1. Départements d'Anesthésie-Réanimation, Hôpitaux Universitaires Paris-Sud, Assistance Publique – Hôpitaux de Paris, Paris, France
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  • Jean-Xavier Mazoit

    Corresponding author
    • Départements d'Anesthésie-Réanimation, Hôpitaux Universitaires Paris-Sud, Assistance Publique – Hôpitaux de Paris, Paris, France
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  • This work has been presented as part of the MD thesis of Emilien Purenne.

Correspondence

Jean-Xavier Mazoit, Département d'Anesthésie-Réanimation, Hôpital Bicêtre, F-94275 Le Kremlin-Bicêtre, France

Email: jean-xavier.mazoit@u-psud.fr

Summary

Objectives

Intussusception is the most frequent cause of bowel obstruction in children. Although enema is usually used as the initial treatment, surgery may be required in more than 50% of patients. General anesthesia (GA) has been suggested to increase the rate of enema success. The purpose of this study was to evaluate whether GA increases the success rate of reduction by air enema.

Methods

In this retrospective single-center study from 1989 to the end of June 2008, patients receiving air enema for intussusception reduction were studied. Multivariable analysis using propensity score was performed to compare the success rate between patients receiving sedation or GA.

Results

The success rate of air enema increased from 72% in 1989 to the current rate of 90%. When time elapsed between first symptoms and enema was >12 h, the success rate decreased significantly (Odds Ratio 0.67 [0.56–0.81], P < 0.0001). When patients were matched by propensity score, GA significantly increased the likelihood of success (OR 5.66 [2.85–12.89], P = 0.013).

Conclusions

Air enema performed under GA allows intussusception reduction in more than 90% of patients.

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