I heard that too, Bob.  But I also heard that having the patient scream adds intra-abdominal pressure and allows the procedure to go more smoothly (higher success rate).
However, the Israeli study, Pediatr Radiol. 2012 Feb 2. Deep sedation during pneumatic reduction of intussusception. By Ilivitzki A1, Shtark LG, Arish K, Engel A. (there n was 131)
proves what you and I learned was nothing but bubbe meisas (yiddish for grandma's stories).  And I would argue it is inappropriate to perform such a procedure with no sedation given the current data.
I am still arguing that with our radiologists...


Joshua A Rocker, MD, FAAP, FACEP
Associate Chief, Division of Pediatric Emergency Medicine
Assistant Director, Pediatric Emergency Medicine Fellowship
Steven and Alexandra Cohen Children's Medical Center of New York
North Shore-Long Island Jewish Health Systems
269-01 76th Ave
New Hyde Park, NY 11040
Phone: 718-470-3403
Fax: 718-470-3473
From: Pediatric Emergency Medicine Discussion List [[log in to unmask]] On Behalf Of Robert Flood [[log in to unmask]]
Sent: Monday, May 12, 2014 5:06 PM
To: [log in to unmask]
Subject: Re: Intussusception and sedation

Whether this is urban legend or fact, I was taught during my fellowship
that sedation should not be given for air contrast and/or barium enemas
since it relaxes the anal sphincter, making the pressure seal less than
optimal for reductions.

Bob Flood
Saint Louis University

On Mon, May 12, 2014 at 11:02 AM, Giora Weiser <[log in to unmask]>wrote:

> Hi,
> I am trying to find out what is the common practice in the big world...
> Here in Israel, when a child is diagnosed with an intussusception he will
> go to the radiology department for an air enema. There is a wide range of
> opinions whether sedation should be given for this procedure. The latest
> article that actually comes from Israel showed success with sedation.
> I was wondering what is accepted in the bigger medical centers? Is
> sedation used? Is it given by the EM people? A sedation service?
> Anesthisiology?
> Anyone know of good literature on the subject...?
> Thanks for the info,
> Giora Weiser
> Shaare Zedek Medical Center
> Jerusalem, Israel
> For more information, send mail to [log in to unmask] with the
> message: info PED-EM-L
> The URL for the PED-EM-L Web Page is:

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