This pilot randomized controlled trial shows that thoracoscopic repair of CDH is associated with prolonged and severe intraoperative hypercapnia and acidosis, compared with open surgery. These findings do not support the use of thoracoscopy with CO2 insufflation and conventional ventilation for the repair of CDH, calling into question the safety of this practice. The effect of thoracoscopy on blood gases during repair of EA/TEF in neonates requires further evaluation. (ClinicalTrials.gov Identifier: NCT01467245).

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SummaryCodeine and morphine were compared in a double-blind studv of postoperative analgesia in 40 patients afrer intracranial neurosurger.r. Eighteen patients received codeine phosphate 60 nig and 18 morphine sulphate 10 mg, both by intramuscular injection; 4 patients (10%) required no analgesia. Both drugs provided analgesia within 20 min of injection but morphine was more efectirw than codeine beyond 60min ( p = 0.01). Fewer doses of morphine than codeine were required (j = 0.003). Nine patients requested one dose qf morphine and 9 two doses. Seoen patients required three doses of codeine and I patient required ,four doses. Neither drug caused respiratory depression, sedation, pupillary constriction or unwanted cardiooascular efects. We conclude that, in the doses used, morphine is a safe alternative to codeine .for analgesia after neurosurgery and has a more persisten! action.