No abstract

We have used the single space combined spinal-extradural technique for mothers requesting analgesia in labour. Intrathecal plain bupivacaine 5 mg produced a median time to analgesia of 3 min. There was inadequate abdominal analgesia after 10 min in 16% of recipients, although all had good perineal analgesia. The median height of block was T8 (range T4-L2) and mean duration of analgesia 72 (SD 21) min. Hypotension occurred in two of 30 mothers, but responded to fluids and ephedrine. There were no post-spinal headaches. This technique is suitable for those parturients requesting analgesia in active labour who may not have time to achieve extradural analgesia before delivery. The extradural catheter is used to improve analgesia if the subarachnoid block is inadequate, or if labour continues beyond the duration of the subarachnoid block.

SummaryA case is presented of a young woman with advanced cervical cancer invading the rectum and sacral nerves giving rise to an intractable pain state. The management of her symptoms using a domicillary infusion of diamorphine with high doses of ropivacaine is described. It is believed that this is the first presentation of ropivacaine being used in daily doses approaching 2 g, and the associated problems are discussed.

Jupiter's Trojan asteroids fulfill the prediction of Lagrange that orbits can be stable when a small body orbits in specific locations relative to its 'parent' planet and the Sun. The first such Trojan asteroid was discovered slightly over one hundred years ago, in 1906, and subsequently similar asteroids have been discovered associated with Mars and with Neptune. To date no Trojans have been discovered associated with Earth, but several horseshoe asteroids, co-orbital asteroids moving along a large range of the Earth's orbit, have been found. Other planets also are not known to have Trojan-type asteroids associated with them. Since the number of detected Jupiter Trojans has increased dramatically in the last few years, we have conducted a numerical survey of their orbital motions to see whether any in fact move in horseshoe orbits. We find that none do, but we use the enlarged database of information about Trojans to summarize their properties as now known, and compare these to results of theory.