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.
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http://dx.doi.org/10.1111/j.1460-9592.2004.01518.x | DOI Listing |
Introduction: Iatrogenic injury to the ilioinguinal nerve and its branches during anterior inguinal hernia repair is a cause of chronic inguinal pain in up to 12 % of patients undergoing this operation. The risk of nerve injury is high, given the nerves' relatively small caliber and strictly-confined space through which they pass. In the current report, we describe using a novel fluorescence imaging system developed to detect nerve autofluorescence in a 66-year-old man who presented with a left-sided Type II inguinal hernia and underwent inguinal hernioplasty.
View Article and Find Full Text PDFANZ J Surg
January 2025
Department of Surgery, MGM Medical College and Lions Seva Kendra Hospital, Kishanganj, Bihar, India.
Int J Surg Case Rep
January 2025
School of postgraduate, Amoud University, Somalia; Faculty of Science, Charles University, Czechia. Electronic address:
Introduction: Giant inguinoscrotal hernias (GIH), defined as hernias extending below the inner thigh midpoint in a standing position, are rare and often seen in resource-limited settings due to delayed medical care. These hernias pose surgical challenges, particularly in low- and middle-income countries (LMICs), where standardized management protocols are lacking, and risks such as cardiorespiratory compromise are significant.
Case Presentation: A 55-year-old male presented with a large, irreducible right inguinoscrotal hernia of 1.
World J Gastrointest Surg
January 2025
Department of Pediatric Surgery, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou 363000, Fujian Province, China.
Background: Routinely separating the ligamentum teres uteri (LTU) intraoperatively remains an unresolved issue for female children undergoing surgery for indirect inguinal hernia (IIH).
Aim: To identify the effect of LTU preservation in laparoscopic high hernia sac ligation (LHSL) in children with IIH.
Methods: The participants were 100 female children with unilateral IIH admitted from April 2022 to January 2024 to the Pediatric Surgery Department of Zhangzhou Municipal Hospital of Fujian Province.
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