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Background: Laparoscopic percutaneous extraperitoneal closure (LPEC), introduced as an alternative to a conventional open inguinal hernia repair in children, has shown a higher incidence of postoperative vomiting (POV). The aim of this study was to examine whether a prophylactic use of diphenhydramine can decrease the incidence of POV in children undergoing LPEC., Methods: We studied 60 girls between 1 and 6 years of age with ASA physical status I or II undergoing LPEC. Patients were allocated to receive either diphenhydramine 1 mg x kg(-1) intravenously (n = 30) or placebo (n = 30) during the operation. Anesthesia was performed with air-oxygen-sevoflurane in combination with epidural anesthesia. Opioids were avoided throughout the perioperative period. The incidence of POV was recorded postoperatively., Results: Demographic data were similar between the groups. The overall incidence of POV during the first 24 postoperative hours was significantly higher in the placebo group (56.7%) than in the diphenhydramine (6.7%) group (P < 0.01). The wake-up in the ward was significantly prolonged in the diphenhydramine group than control group., Conclusions: Prophylactic use of diphenhydramine substantially reduced the risk of postoperative vomiting, but was associated with prolonged sedation in pediatric patients undergoing LPEC.

The US oncology 9735 study showed the superior result of TC (docetaxel/cyclophosphamide) over AC (doxorubicin/cyclophosphamide), and now TC has been widely adopted for the treatment of early breast cancer. But in Japan there are few data on the safety and tolerability of this regimen. From January 2007 to April 2009, we treated 51 early breast cancer patients with TC in our hospital, and we summarized safety and tolerability profile, including hematologic toxicity and nonhematologic toxicity. Our patients experienced more febrile neutropenia (25.5%) compared with the original USO 9735 result (5%). This might be because we did not use prophylactic oral antibiotics. Skin toxicity was sometimes troublesome, including 3 cases (5.9%) of grade 3 skin rash. Toxicity assessment showed more asthenia, edema, neuropathy and myalgia, as is well known. Finally, we recommend prophylactic oral antibiotics, steroid premedication from the day before treatment and skin moisture, which may minimize the toxicity.