MelbourneThis paper reviews reports on the incidence and importance of postoperative nausea and vomiting, and concludes that the main predisposing factors are the agent and technique used, premedicant drugs, the operation site, the age and sex of the patient and the duratioia of the operation. (The patient's) dread of the anzesthetic is not because of its danger . . . but because of the sickness which he anticipates as an inevitable consequence.-BLUMFELD, Lancet, I @ . THE IMPORTANCE OF POSTOPERATIVE VOMITING Although less important than formerly, nausea and vomiting remain unpleasant and sometimes serious sequela of anzsthesia. Riding (1963) lists the complications of postoperative nausea and vomiting as: I. Discomfort, possibly with soiling of clothing and bedding. 2. Aspiration of vomitus, and its harmful effects. 3. Strain on suture lines and promotion of haemorrhage, seriously jeopardizing good surgical results, particularly in eye and plastic operations. 4. Electrolyte disturbances, which, however, are rare. Bellville (1961) includes in this category trauma to the esophagus, interference with * Present address : Department of Anzsthesia, Royal Children's Hospital, Melbourne.proper nutrition and inability to tolerate oral medication. It is clear that remedial measures will be worth while provided that they do not cause complications of their own.
Deep hypothermia is now employed for open heart surgery in infants. The method of surface cooling infants to 25° C and then by-pass cooling down to 15–20° C prior to exsanguination is described. This provides a still heart and ideal operating conditions. The infants are re-warmed on by-pass. Some of the physiological effects of hypothermia and the methods employed to counteract these are discussed. The aims are to reduce temperature gradients, improve cerebral oxygen supply, avoid arrhythmias and secure haemostasis. The experience in 33 operations is outlined. Seventeen patients were under one year of age.
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