Tolerance and analgesic efficacy of a new i.v. paracetamol solution in children after inguinal hernia repair.

BACKGROUND: A new intravenous (i.v.) formulation of paracetamol and propacetamol (prodrug of paracetamol) were compared to determine tolerance and relative analgesic efficacy during the first 6 h after inguinal hernia repair performed under general anesthesia combined with ilioinguinal block in children. METHODS: A total of 183 ASA I or II in-patients, aged 1-12 years, admitted for unilateral inguinal hernia repair were randomized to receive in a double-blind design either i.v. paracetamol 15 mg.kg(-1) (n = 95) or propacetamol 30 mg.kg(-1) (n = 88) for postoperative pain relief as soon as pain intensity was greater than 30 on a 100 mm visual analog scale. All patients were evaluated for efficacy and tolerance. Efficacy was evaluated between 15 min and 6 h after the start of the 15 min infusion. RESULTS: The most frequently reported adverse event was injection site pain, which was significantly reduced in the new formulation group (i.v. paracetamol 14.7% vs propacetamol 33.0% of children, P = 0.005). No significant difference was obtained between treatments on pain relief (PR), pain intensity difference (PAID) from baseline, and objective pain scale intensity difference (OPSD). Also, treatment effects did not differ significantly for maximum values and weighted sums of PR, PAID (investigator and child rated), OPSD, time to first request for rescue medication, proportion of children requesting rescue medication, and investigators' global treatment satisfaction. CONCLUSION: A single infusion of i.v. paracetamol 15 mg.kg(-1) produced analgesia similar to a single infusion of propacetamol 30 mg.kg(-1) following inguinal hernia repair in children. Paracetamol i.v. 15 mg.kg(-1) was better tolerated at the injection site than propacetamol.

[Traumatic pulmonary evisceration in a child. Apropos of 2 cases]. / L'éviscération pulmonaire traumatique chez l'enfant. A propos de 2 cas.

Two cases of pulmonary traumatic evisceration are reported. The question is about exceptional lesions very spectacular and good tolerated.

[Bronchography in children]. / La bronchographie chez l'enfant

In spite of improvement in the exploratory techniques of the respiratory tract, tracheo-bronchography preserves numerous indications in the study of children's congenital or acquired bronchopneumopathies. The main indications of this investigation consist in the detection of bronchectasies or in the exploratory study of chronic and relapsing bronchial diseases. The investigation makes possible to precise the severity of the disease, to value the results of the medical management and, at last, to select the patients amenable to surgery. Another indications are to be found in the appraisal of some malformative broncho-pneumopathies, with special reference to lung hypoplasias and sequestrations. The technical conditions of the investigation have largely benefited of short duration general anesthesy and of various material improvements (televised fluoroscopy, orientable catheters of small calibre).