30 The association between fentanyl and failed reduction in children with intussusception
Bibliographic record
Abstract
Abstract Background Ileocolic intussusception is an important cause of bowel obstruction in children. Reduction is likely painful but neither sedation nor analgesia are routinely provided. Societal bodies strongly advocate for management of procedural pain in children. Fentanyl is a potent analgesic with minimal adverse effects. We sought to determine whether fentanyl was associated with failed reduction in children with intussusception. Objectives The objective of this global cross-sectional study was to determine if fentanyl was associated with failed reduction in children with intussusception. Design/Methods This was a secondary analysis of a cross-sectional study characterizing the association of opioid analgesia and sedation with intestinal perforation and failed reduction in a consecutive sample of children 4 months to 4 years with a discharge diagnosis of ileocolic intussusception from 86 paediatric tertiary care centres in 14 countries between January 1st, 2017, and December 31st, 2019. Data were analyzed in June 2024. We conducted separate multivariable analyses to determine the relationship between fentanyl as an analgesic or sedative adjunct and failed reduction. Results We included 3184 patients (2038/3148, 64% males); median (IQR) age of 17 (9,27) months. Opioid +/- non-opioid analgesia and sedation were documented in 394/3131 (12.6%) and 333/3157 (10.5%) patients, respectively. Failed reduction occurred in 484/3184 (15.2%) patients. In the adjusted analysis, younger age (OR:0.96; 95%CI:0.95,0.97), longer triage to reduction time (OR:1.04; 95%CI:1.01,1.07), pre-existing gastrointestinal anomalies (OR:4.39; 95%CI:1.51,12,78), and opioids excluding fentanyl (OR:1.59; 95%CI:1.07,2.39) were associated with failed reduction but not fentanyl. Conclusion Fentanyl, whether used as an analgesic or sedative adjunct, was not associated with failed reduction of intussusception. Our findings inform analgesic management in children undergoing this likely uncomfortable procedure.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".