Key Points Question Did the delivery of services within a cancer system change during the first year of the COVID-19 pandemic? Findings This population-based cohort study conducted in Ontario, Canada, found a total of 4 476 693 cancer care services during the first year of the COVID-19 pandemic, compared with 5 644 105 services in the year prior, representing a reduction of 20.7% and suggesting a backlog of 1 167 412 cancer services during the first pandemic year. Limited change was observed in systemic treatments and emergency or urgent imaging examinations and surgical procedures, while major reductions were observed in cancer screening tests, biopsies, surgical treatments, and new consultations for systemic and radiation treatment. Meaning These findings provide evidence on the deficits in cancer care that occurred during the first year of the COVID-19 pandemic that are likely to inform continued delivery of care, recovery, and future pandemic planning.

We conclude that laparoscopy is a reasonable approach to pediatric intussusception, even in the event when bowel resection is necessary.

SummaryWe compared the postoperative effects, in particular nausea and vomiting, of two commonly used anaesthetic agents, isoflurane and desflurane, in patients undergoing day-case arthroscopic surgery. We found a significantly higher incidence of postoperative nausea and vomiting in those patients receiving desflurane. In our study, desflurane was associated with a higher incidence of peroperative respiratory complications, including airway irritability and coughing. Accepted: 20 February 1998 Postoperative nausea and vomiting (PONV) is a major side-effect of general anaesthesia [1]. If PONV occurs in patients undergoing day-case surgery, it may result in delayed discharge, or even overnight admission. Hence an anaesthetic agent with a good recovery profile is particularly advantageous for day-case surgery. Desflurane, a relatively new fast-acting agent, is an attractive agent for day-case surgery [2][3][4]. Theoretically, its low blood/gas solubility should ensure rapid offset. However, its emetogenic potential has not been thoroughly investigated. In our study, we compared the effects of this drug with isoflurane, an agent which has been widely used in a day-case environment [5]. MethodsWith the approval of the local ethics committee and after written informed consent had been obtained, we studied 156 ASA physical status 1 and 2 unpremedicated patients who were scheduled for day-case arthroscopic knee surgery. Patients studied were between the ages of 16 and 70 years. Pre-operatively, details of medical history, including PONV, smoking and current medications, were noted. The patients' weights and blood pressures were recorded.Patients with previous adverse reactions to any of the proposed anaesthetic agents were not studied.In the anaesthetic room, the patient was monitored with noninvasive blood pressure and pulse oximetry. Intravenous access was established and propofol (3-4 mg.kg À1 ) was used to induce anaesthesia. This was supplemented with a single bolus of fentanyl (1-1.5 g.kg À1 ). Ventilation was gently supported with 100% oxygen until diminished muscle tone allowed insertion of a laryngeal mask airway (LMA). The LMA was secured and a capnograph was attached. Patients were randomly allocated to receive either isoflurane or desflurane in a mixture of 33% oxygen in nitrous oxide. Manual ventilation was discontinued when spontaneous respiration recommenced.In the operating theatre, the electrocardiogram, oxygen saturation and end-tidal carbon dioxide were assessed continuously. Noninvasive blood pressure was measured every 3 min. The selected volatile agent was administered at a concentration approximating to twice MAC for a period of 3 min. After this time, the inspired vapour concentration was adjusted according to clinical assessment of the patient's requirements; 4-7% for desflurane and 1-2.5% for isoflurane, previous studies having demonstrated these to balance appropriate anaesthetic Anaesthesia, 1998 910ᮊ 1998 Blackwell Science Ltd depth with cardiovascular and respiratory stability. Any ca...

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