title: General anesthesia for intussusception reduction by enema.
abstract: OBJECTIVE
  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.
authors.affiliation: Département d'Anesthésie-Réanimation, Hôpitaux Universitaires Paris-Sud, Assistance Publique - Hôpitaux de Paris, Paris, France.
authors.forename: Emilien
authors.initials: E
authors.lastname: Purenne
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Franchi-Abella
authors.forename: Sophie
authors.initials: S
authors.lastname: Branchereau
authors.forename: Catherine
authors.initials: C
authors.lastname: Baujard
authors.forename: Dan
authors.initials: D
authors.lastname: Benhamou
authors.forename: Jean-Xavier
authors.initials: JX
authors.lastname: Mazoit
mesh_terms: D000768:Anesthesia, General / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation; D013505:Digestive System Surgical Procedures / Q000379:methods*; D004733:Enema / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D007443:Intussusception / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome