SummaryOne hundred and sixty six patients were questioned by means of a multiple choice questionnaire, to determine their knowledge of peri-operative care, anaesthesia and the r61e of anaesthetists. In general, knowledge was good, but there were some important misconceptions; in particular, 28.3% of respondents thought that fasting referred to food only, and not to fluid intake. In addition, 47.6% of respondents considered pain to be a necessary part of the healing process and 38.6% believed that it was something that just had to be endured. When .forthcorning anaesthesia is discussed, anaesthetists need to ascertain that patients really do understand the language used.

The ability of adolescents to access safe and effective new products for HIV prevention and treatment is optimised by adolescent licensure at the same time these products are approved and marketed for adults. Many adolescent product development programmes for HIV prevention or treatment products may proceed simultaneously with adult phase III development programmes. Appropriately implemented, this strategy is not expected to delay licensure as information regarding product efficacy can often be extrapolated from adults to adolescents, and pharmacokinetic properties of drugs in adolescents are expected to be similar to those in adults. Finally, adolescents enrolled in therapeutic HIV prevention and treatment research can be considered adults, based on US Food and Drug Administration (FDA) regulations and the appropriate application of state law. The FDA permits local jurisdictions to apply state and local HIV/sexually transmitted infection minor treatment laws so that adolescents who are HIV-positive or at risk of contracting HIV may be enrolled in therapeutic or prevention trials without obtaining parental permission.

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Correspondence 837had an uneventful laparotomy. There was no evidence of intrathecal spread of local anaesthetic. Postoperatively, an epidural infusion was commenced but within 24 h clear fluid was observed through the transparent dressing to be leaking from around the catheter site. This tested positive for glucose and the catheter was removed. During the next 3 days, in excess of 300ml CSF was collected from the puncture site and then the leak stopped. Unlike the cases of Howes and Lentz, at no time did our patient develop a headache and a blood patch was not necessary. However, this occurrence does seem to lend support to the theory that multiple attempts may predispose to the formation of CSF fistulae, perhaps by fibrin deposition in the tract [I].We do also advocate the use of transparent dressings when epidurals are left in situ for an appreciable length of time.

A case of recurrent respiratory depression due to rectal absorption of concealed opiate drugs in an intravenous drug abuser held in police custody is described. The importance of rectal examination in intravenous drug abusers in police custody is stressed and it is emphasised that drugs may have been concealed in a body cavity at the time of arrest. The use of both the intramuscular and intravenous route for the administration of naloxone in treatment of unconscious intravenous drug abusers suspected of having overdosed on opiates is advocated as these patients frequently discharge themselves from hospital on regaining consciousness and may later present with recurrent respiratory depression.