[Use of MEOPA during nasolacrimal duct probing in children].
BACKGROUND
Congenital nasolacrimal duct obstruction affects more than 6% of newborns. Whereas some recommend nasolacrimal probing under general anesthesia from 1 year of age when the condition does not spontaneously resolve, some decide in favor of early probing from 4 to 6 months of age with topical anesthesia. We present nasolacrimal probing with inhalation of MEOPA, an equimolar mixture of nitrous oxide and oxygen, as a therapeutic alternative.


METHODS
We conducted a descriptive, prospective study including 63 children (75 eyes) who had nasolacrimal duct probing with inhalation of MEOPA between March 2005 and March 2006, in consultation. Efficacy was estimated by the observation of medical staff and parents and by the feasibility of the probing procedure.


RESULTS
Children were 4-28 months old (mean age, 11.5 months). Symptoms resolved spontaneously in 79% of cases after only one probing. No incident was observed. In case of failure, probing with nasolacrimal intubation with nasal endoscopy and general anesthesia was done (21% of cases, mean age, 17.5 months).


CONCLUSIONS
Administration of MEOPA, by inhalation with a facial mask, is already used for minor pediatric surgical procedures. It is simple to use, fast, low-risk, inexpensive, and effective.


CONCLUSIONS
Use of MEOPA in nasolacrimal duct probing in children could be a good alternative, making it possible to alleviate pain in the youngest children and general anesthesia in the oldest.
Service d'Ophtalmologie, CHU de Tours, Hôpital Bretonneau, Tours. gitteau.lala@free.fr
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E
Lala-Gitteau
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Majzoub
P-J
PJ
Pisella
D000758:Anesthesia / Q000379:methods; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D002675:Child, Preschool; D003608:Dacryocystorhinostomy / Q000379:methods*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007223:Infant; D007767:Lacrimal Duct Obstruction / Q000151:congenital; D008297:Male; D009301:Nasolacrimal Duct; D009609:Nitrous Oxide / Q000008:administration & dosage*; D010100:Oxygen / Q000008:administration & dosage*; D017601:Oxygen Compounds / Q000008:administration & dosage*; D011446:Prospective Studies
D018685:Anesthetics, Inhalation; D004338:Drug Combinations; C576493:Meopa; D017601:Oxygen Compounds; D009609:Nitrous Oxide; D010100:Oxygen