Background and Goal of Study:The use of hypotonic intravenous fluids has been associated with more than 50 international case reports of death or neurological injury in children. In 2003 the Royal College of Anaesthetists warned of the risk of iatrogenic hyponatraemia and water overload developing after the use of sodium chloride 0.18% with glucose 4% in children. A followup survey found less than half of consultant anaesthetists had been aware of this warning. 1 Our audit looked at whether anaesthetists' fluid prescriptions intraoperatively and postoperatively reflected these concerns in our department. Materials and Methods:The audit examined the fluid administration in paediatric operations over a 4 month period. Data collected included the age and weight of the child, the volume, rate and type of fluid prescribed intraoperatively and postoperatively, whether there was any estimate of blood or fluid loss, and whether capillary blood sugar was recorded.We also recorded the current locations of sodium chloride 0.18% with glucose 4%. Results and Discussions: Over the 4 month period, 35 patients received intraoperative fluids: none had a capillary blood sugar recorded and only 1 had an estimate of blood or fluid loss. 31 were given isotonic solutions, at volumes between 3-34 ml/kg. 4 were given hypotonic solutions (2 at 10-20 ml/kg, 2 at greater volumes).Only 17 patients were prescribed postoperative fluids: 13 were given isotonic solutions, of which only 4 were prescribed according to the Holliday and Segar formula. 2 The majority were prescribed at greater rates. 4 were given hypotonic fluids, 1 at the predicted rate, 2 at a greater rate and 1 at almost half the calculated rate. 2 Sodium chloride 0.18% with glucose 4% solution was freely available in all clinical areas. Conclusion(s):There is no restriction in the availability of sodium chloride 0.18% with glucose 4% solution. The majority of paediatric patients are given isotonic fluid intraoperatively. However, despite the concerns about hyponatraemia, post-operatively the majority are being prescribed either hypotonic or excessive rates of fluid.

Incidence of intraoperative hypoxemia during interventional rigid bronchoscopy for tracheobronchial stenosis under spontaneous-assisted ventilation was 25.5%. Risk factors for hypoxemia were a degree of tracheal stenosis ≥75% and tumor removal procedure.

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Spinal anesthesia can be safely administered to severely pre-eclamptic parturients undergoing cesarean section. General anesthesia is associated with more untoward outcomes, as it has been chosen in patients with more severity of the disease.