{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T01:35:55Z","timestamp":1779240955318,"version":"3.51.4"},"reference-count":21,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2017,9,20]],"date-time":"2017-09-20T00:00:00Z","timestamp":1505865600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Hydrostatic or pneumatic reduction of intussusception is an invasive procedure that is stressful and may be painful for a child. Resistance of the child may increase the duration of the procedure and decrease success rate of reduction. Analgesia can help to reduce pain, but not necessarily resistance. General anesthesia increases success rate of reduction. However, it requires the presence of an anesthesiologist, and may lead to anesthesia\u2010related complications. Procedural sedation with esketamine could be a safe alternative.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>The aim of this study was to compare hydrostatic reduction using morphine analgesia compared to procedural sedation with esketamine in terms of success rate, adverse events, and duration of reduction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective case\u2010cohort comparison study was performed with two groups of patients who had undergone hydrostatic reduction for ileocolic intussusception and received morphine analgesia (n\u00a0=\u00a037) or esketamine sedation (n\u00a0=\u00a020). Until July 2013, reduction was performed after intravenously administered morphine. Hereafter, a new protocol for procedural sedation was implemented and reduction was performed after administration of esketamine. Cases were matched for age and duration of symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>No adverse events requiring intervention other than administration of oxygen were reported for either group. Success rate of reduction using esketamine sedation was 90% vs 70% using morphine analgesia, risk ratio (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>) 1.29, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>[0.93\u20101.77]. Recurrence rate using esketamine sedation was 10% vs 15% using morphine analgesia, <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 0.67, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>[0.12\u20103.57]. Reduction time was shorter using esketamine sedation (Median 5\u00a0minutes, <jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content> 9\u00a0minutes) vs morphine analgesia (Median 8\u00a0minutes, <jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content> 16\u00a0minutes, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.04, Median difference 3, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>[\u22121.50\u20108.75]). Median hospital stay in the esketamine group was 1.5\u00a0days (<jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content> 1.8) vs 2\u00a0days (<jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content> 5.3) in the morphine group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>No serious adverse events were recorded. In comparison to morphine analgesia, with esketamine there was weak evidence for a higher success rate, lower recurrence rate, shorter duration, and shorter length of hospital stay.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.13226","type":"journal-article","created":{"date-parts":[[2017,9,20]],"date-time":"2017-09-20T11:52:37Z","timestamp":1505908357000},"page":"1091-1097","source":"Crossref","is-referenced-by-count":45,"title":["Effects of esketamine sedation compared to morphine analgesia on hydrostatic reduction of intussusception: A case\u2010cohort comparison study"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1555-3452","authenticated-orcid":false,"given":"Jascha A.","family":"van de Bunt","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery University Medical Centre Utrecht Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther S.","family":"Veldhoen","sequence":"additional","affiliation":[{"name":"Department of Pediatric Intensive Care University Medical Centre Utrecht Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rutger A. J.","family":"Nievelstein","sequence":"additional","affiliation":[{"name":"Department of Radiology University Medical Centre Utrecht Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline C. C.","family":"Hulsker","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery University Medical Centre Utrecht Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonius N. J.","family":"Schouten","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University Medical Centre Utrecht Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maud Y. A.","family":"van Herwaarden","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery University Medical Centre Utrecht Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,9,20]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12035"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arcped.2012.04.001"},{"key":"e_1_2_10_4_1","unstructured":"NVA\/NVK.Guideline sedation and\/or analgesia (PSA) on locations outside the operating room: part III: in children. 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