A randomized trial of lumbar epidural injections for the treatment of acute sciatic pain was carried out. All the patients had unilateral sciatica for less than six months and had never previously been treated in hospital for their backs. The treatments used were 20 ml normal saline, 80 mg Depomedrone in normal saline made up to 20 ml, 20 ml, 20 ml 0.25% bupivacaine solution and needling with a standard Touhy injection needle into the interspinous ligament but with no injection. The patients improved at about the same rate for all four treatments. Overall, 75% of the patients improved or were cured. As some of these were in the group treated by needling of the interspinous ligament, it seems likely that the epidural injections administered achieved effects partially as a placebo and partially by virtue of the natural history of the acute sciatic syndrome.

Summary One hundred unpremedicated fit day surgery patients aged between 27 and 68 years were allocated randomly into one of four groups and EMLA, glyceryl trinitrate, EMLA and glyceryl trinitrate or a placebo ointment was applied to the dorsum of a hand. The pain and ease of venepuncture were determined at induction of anaesthesia 60 minutes later. Pain scores were also reassessed 1–2 hours after operation. Lower pain scores and easier venepuncture occurred when EMLA and glyceryl trinitrate ointment was applied to the dorsum of the hand.

A study of the time and motion of the anaesthetists' routine activities was made using conventional equipment. Films of manual and visual movements were studied in detail and the expectations of certain consultant anaesthetists regarding apparatus were recorded. Models of apparatus were used to test their acceptability. A modular system appeared preferable to a work station or to adaptation of present designs. More work and the construction of prototypes are indicated if the anaesthetic machine is to be modernized.

SummaryThe e[/ect of,free:ing the ilioinguinal nerve on postoperative pain relief was examined in a double blind study in 36 patients undergoing herniorrhaphv. randomly allocared into two groups. Patients in the experimental group had their ilioinguinal nerves .fro:en during .surgery and were compared with the patients in rhe control group who did nor huve cryoanalgesia. Pain relief was assessed overa 48-hour period in three ways, namely the linear analogue pain scale, peak espiratory ~7 o w rates and the amounr of analgesic drugs required by patients in the two groups. We conclude that cryoanalgesia of rhe ilioinguinal nerve alone does not produce significant early post herniorrhaphy pain relief.

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