The aim of this study was to document clinical features of inguinal hernia (IH) in the pediatric populace. It delivers data to assess related risk factors of incarcerated hernia, its reappearance in addition to the occurrence of contra lateral metachronous hernia. Materials and Methods: We report a retrospective analytic study comprising 230 children presenting with IH and operated from April 2015 to June 2017 in the pediatric surgery department, King Abdulaziz Hospital. Results: We managed 36 girls (15.6%) and 194 boys (84.4%). The mean age was 3 years; The median age in the studied group was 3 years (range 22 days to 12 years). Males were predominantly affected (84.4%, n = 194). The rate of IH was more important in the youngest group (age < 2 years); thus, we accounted 43.5% (n = 100) infants. The cumulative incidence of hernia in the 2-6-year age group was 34.7% (n = 80). Thirteen percent (n = 31) of these patients presented with an incarceration mostly on the right side (62.6%, n = 154). We recognized that the total rate of incarcerated hernia incidence in premature group was evaluated at 27%. This rate was high, particularly in neonates and infants. Prematurity and hypotrophy were documented in 9% and 7% respectively. The mean follow-up period was 3.8 years. We think that incarceration can be related to several risk factors such as feminine gender, prematurity, and the initial left side surgical repair of the hernia. Conclusion: IH occurs mainly in male infants. Prematurity and male gender was identified as risk factors of incarceration. Contralateral metachronous hernia was reported, especially in female infants and after a left side surgical repair of the hernia.

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Background: The co-administration of ketamine and propofol (CoKP) is thought to maximize the beneficial profile of each medication, while minimizing the respective adverse effects of each medication. Objective: Our objective was to compare adverse events between ketamine monotherapy (KM) and CoKP for procedural sedation and analgesia (PSA) in a pediatric emergency department (ED). Methods: This was a prospective, randomized, single-blinded, controlled trial of KM vs. CoKP in patients between 3 and 21 years of age. The attending physician administered either ketamine 1 mg/kg i.v. or ketamine 0.5 mg/kg and propofol 0.5 mg/kg i.v. The physician could administer up to three additional doses of ketamine (0.5 mg/kg/dose) or ketamine/propofol (0.25 mg/kg/dose of each). Adverse events (e.g., respiratory events, cardiovascular events, unpleasant emergence reactions) were recorded. Secondary outcomes included efficacy, recovery time, and satisfaction scores. Results: Thirty-two patients were randomized to KM and 29 patients were randomized to CoKP. There was no difference in adverse events or type of adverse event, except nausea was more common in the KM group. Efficacy of PSA was higher in the KM group (99%) compared to the CoKP group (90%). Median recovery time was the same. Conclusions: We found no significant differences in adverse events between the KM and CoKP groups. While CoKP is a reasonable choice for pediatric PSA, our study did not demonstrate an advantage of this combination over KM.