Persistent diplopia can occur after cataract surgery using retrobulbar block predominantly through direct damage to the inferior rectus muscle. The overall incidence of anaesthesia-related diplopia in this series was 0.25%.

A simple index such as the RISK-VAS scale was the best predictor of serious post-operative complications. The functional level before the fracture, measured with the Barthel index, had a major influence on the ambulation recovery.

SummarySome, but not all studies have suggested intra-operative use of nitrous oxide is correlated with postoperative nausea and vomiting. We performed a meta-analysis of randomised controlled trials to compare the incidence of nausea and vomiting in adults following general anaesthesia with or without nitrous oxide. We retrieved 30 studies (incorporating 33 separate trials) that investigated a 'nitrous oxide group' (total 2297 patients) vs a 'no-nitrous oxide group' (2301 patients). Omitting nitrous oxide significantly reduced postoperative nausea and vomiting (pooled relative risk 0.80, 95% CI 0.71-0.90, p = 0.0003). However, the absolute incidence of nausea and vomiting was high in both the nitrous oxide and no-nitrous oxide groups (33% vs 27%, respectively). In subgroup analysis, the maximal risk reduction was obtained in female patients (pooled relative risk 0.76, 95% CI 0.60-0.96). When nitrous oxide was used in combination with propofol, the antiemetic effect of the latter appeared to compensate the emetogenic effect of nitrous oxide (pooled relative risk 0.94, 95% CI 0.77-1.15). We conclude that avoiding nitrous oxide does reduce the risk of postoperative nausea and vomiting, especially in women, but the overall impact is modest. Postoperative nausea and vomiting (PONV) is probably the most common cause of morbidity following anaesthesia [1], occurring in 20-30% of patients (but in up to 70% of those with certain risk factors [2]). Sometimes considered a minor, unavoidable complication, many patients perceive PONV as highly unpleasant, and some even describe it as worse than postoperative pain [3]. PONV increases the cost of procedure because anti-emetic medication becomes necessary, or because discharge from hospital is delayed.Marked advances have been made in our knowledge of risk factors associated with PONV, and predictive scoring systems have been developed [4]. However, the pathophysiology of PONV is still not well established. Many studies are essentially epidemiological [5], and genetic or molecular mechanisms have not been extensively examined [6].It has been suggested that nitrous oxide (N 2 O) contributes significantly to PONV [7][8][9], perhaps influencing the vestibular system by its diffusion into the closed cavity of the middle ear, or by expanding the intestinal wall or releasing endogenous opioid peptides and activating the area postrema of the brain [10]. While many studies have demonstrated a positive correlation between N 2 O and PONV [11][12][13], others have found no association [14][15][16].When trials reach differing conclusions, a systematic quantitative review of the original randomised clinical trials is a useful method of assessing the evidence. Our main purpose, therefore, was to compare the incidence of PONV in adults following general anaesthesia with or

We compared different concentrations of epidural bupivacaine and ropivacaine thought to be equipotent. Both solutions were equally efficient in providing highly effective epidural analgesia for labor with minimal motor block. These findings suggest that bupivacaine may be more potent than ropivacaine.

Sublingual and vaginal misoprostol are safe and effective for mid-trimester pregnancy termination. The differences obtained between both routes probably do not have clinical consequences.