All subjects had significant signs and symptoms of residual block at a TOF ratio of 0.70; none considered themselves remotely "street ready" at this time. The authors believe that satisfactory recovery of neuromuscular function after mivacurium-induced neuromuscular block requires return of the TOF ratio to a value > 0.90 and ideally to unity.

No abstract

Two short-acting benzodiazepines, midazolam 15 mg and triazolam 0.25 mg, were compared with diazepam 10 mg and placebo as oral premedicants in 120 patients presenting for minor urological surgery. Midazolam was found to produce the greatest degree of amnesia and sedation at the time of anaesthetic induction and triazolam was found to have the greatest degree of residual sedation at the time of discharge, four hours postoperatively. These effects are consistent with the greater potency and more rapid onset of action of midazolam at this dose compared with triazolam. The relative merits of the compounds as anxiolytics varied depending upon the observer, time and method of assessment. It was considered that the doses of midazolam and triazolam used were excessive for routine day case anaesthesia.

The association of pregnancy and phaeochromocytoma has been reported on many occasions, and it is now recognised that ante partum diagnosis and treatment can markedly reduce both maternal and foetal mortality from early figures of almost 500;0. 1 -7 Current opinion would suggest that thirdtrimester diagnosis can be followed safely by combined caesarean delivery and tumour resection. Management during the first and second trimester is less well defined, the alternatives being termination of pregnancy, early laparotomy for tumour removal, or medical management until the later stages of pregnancy when a combined procedure can be undertaken. Case History:A 24-year-old, gravida 2, para 1, woman was referred from a peripheral hospital in the 36th week of her pregnancy, for suspected phaeochromocytoma. She had an I8-month history of palpitations, tightness of chest, sweating, flushing and frequent headaches, worse over the duration of her pregnancy, especially in the supine position. Her previous pregnancy four years before had required antenatal admission for hypertension and treatment with methyldopa. After that pregnancy her blood pressure was normal, until she had been found to be hypertensive three months before her second pregnancy, with diastolic recordings of 110 mmHg and had been managed with a combination of bendrofluazide and propranolol, which had been continued up until the time of referral. Urinary catecholamines *F.

These results suggest that if nondepolarizing neuromuscular blockers are administered using tactile evaluation of the TOF count as a guide, critical episodes of postoperative weakness in the postanesthesia care unit should occur infrequently even with long-acting relaxants. Nevertheless, if full recovery is defined as return to a TOF ratio of 0.90 or more, then short-acting agents would appear to offer a wider margin of safety.

No abstract

No abstract

In 60 patients undergoing minor day-stay surgical procedures, a standard inhalational technique of anaesthetic maintenance (halothane/nitrous oxide/oxygen) was compared with incremental dose methohexitone supplemented by nitrous oxide/oxygen. The methohexitone group showed faster immediate recovery but slower overall recovery at four hours. No difference was found in the incidence of minor sequelae up to 24 hours after anaesthesia.