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A new type of analysis of the electromyographic spike obtained from the full interference pattern of extraocular muscles is introduced. It entails the use of a computer for the measurement and statistical analysis of the duration of onset-to-onset from one spike to the next one and the onset-to-onset immediately preceding it. The lateral, medial and superior recti muscles were examined in 13 subjects, of whom 7 were healthy, 3 were suffering from ocular myopathy and 3 from infranuclear neuropathy. Sharp, well-defined differences between healthy, myopathic and neuropathic lesions were found. The technique is simple, rapid and accurate. Its value is enhanced by the fact that no area of overlap was encountered between the 3 basic types of muscle examined. The parameter, and its statistical analysis, appears to be an additional and reliable tool in the interpretation of electromyography (EMG), especially of value in subclinical, incipient or doubtful clinical conditions involving eyeball motility.

Bupivacaine hydrochloride 0.25% and 0.50% solutions, were administered 115 times by the i.v. regional route to 64 surgical patients and in 38 subjects suffering from pain syndromes. The clinical effects were limb numbness up to 20 h following cuff release, while analgesia and weakness of the limb muscles were evident 5 h after the tourniquet. Clinical and electrophysiological findings revealed a dose relationship of the effects. Toxic signs were noted in three patients in whom the cuff was released in a one-step fashion. In 11 patients, mean arterial plasma concentrations of bupivacaine reached 3.7 micrograms ml-1 after administration of 0.5% bupivacaine 40 ml, 5 min after final cuff release, and decreased gradually thereafter. In selected conditions which do not require a bloodless field and in certain intractable pain states, i.v. regional anaesthesia with high-dose bupivacaine (200 mg of 0.5% solution) may be a simple and effective technique.

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