Paracetamol
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Lack of efficacy: case report A female neonate [exact age not stated] exhibited lack of efficacy during analgesic treatment with paracetamol [route and dosage not stated]. The girl, who born at gestational age of 39 weeks, was diagnosed as having interrupted aortic arch (IAA) type B, patent ductus arteriosus (PDA), ventricular septal defect (VSD), and atrial septal defect. At the age of 13 days, she underwent aortic arch reconstruction by extended aortic arch anastomosis, PDA ligation, and VSD patch closure. On post-operative day 2 following the extubation, she presented hoarseness and severe stridor with a subsequent diagnosis of left recurrent nerve palsy. However, stridor occurred while she was asleep. She was uneventfully discharged from the ICU on post-operative day 4. However, her pericardial effusion increased and elective pericardiocentesis was scheduled. Ten milliliters of serosanguineous fluid was drained, and a silicon drainage tube was left in the pericardium. After investigation, there was no presence of pneumothorax or pneumopericardium was confirmed. Then, she extubated in the operating room and transferred to ICU. In the ICU, she developed with tachyponea, hypertension, tachycardia and stridor. For analgesia, she received paracetamol [acetaminophen], but it was not effective. Therefore, she received dexmedetomidine. Despite, she developed a new onset of mandibular breathing in addition to progressive hypotension. Thus, dexmedetomidine was stopped, and she received bag-valve-mask ventilation. Further investigations confirmed a diagnosis of pneumopericardium and pneumomediastinum. Tani M, et al. Successful treatment with positive airway pressure ventilation for tension pneumopericardium after pericardiocentesis in a neonate: a case report. JA Clinical 803519864 Reports 6: 79, No. 1, Dec 2020. Available from: URL: http://doi.org/10.1186/s40981-020-00384-x
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Reactions 12 Dec 2020 No. 1834
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