SummaryArtcviul o\rr%en suturution in I32 putienrs IUIS meu.surrd using a Biox IV

Oral morphine sulphate slow-release ( M S T ) 40 mg and intramuscular morphine sulphate 10 mg, each administered with intramuscular atropine 0.6 mg, were compared in a randomised double-blind trial as premedication agents in 30 patients undergoing abdominal hysterectomy. Both formulations produced sedation but no anxiolysis in the anaesthetic room, as measured by 10 cm, horizontal linear analogue scales. There was no signijcant difference between the preparations in terms of postoperative pain, recorded either by the linear analogue scales or using a patient questionnaire. The usage of analgesics and anti-emetics postoperatively was comparable in both groups. Key wordsAnalgesics, narcotic; morphine. Premedication.The use of opioid drugs for premedication is widespread in current anaesthetic practice. The anxiolytic effects of most opioids are known to be small, but their sedative properties make these agents popular and their analgesic effects contribute to a balanced anaesthetic technique. Oral morphine sulphate in a slow release matrix (MST continus, Napp Laboratories) has recently become available and would appear to offer advantages as a premedicant, notably with regard to ease of administration and patient acceptability in comparison to the intramuscular route.Previous studies from this department have shown that MST 20 mg given four hourly can provide acceptable postoperative analgesia after abdominal surgery,' although a recent study2 has suggested that MST 30 mg is insufficient for premedication, and that 60 mg should be evaluated. The bio-availability of a single dose of MST has been estimated as 18% in our l a b~r a t o r y ,~ although other workers have suggested values exceeding 30%. 4 Accordingly, a dose of MST 40 mg was compared to morphine sulphate 10 mg intramuscularly in a double-blind trial which was designed to answer the following three questions: does MST 40 mg give an equivalent quality of premedication as compared t o morphine 10 mg intramuscularly; does the use of MST 40 mg as a premedicant reduce postoperative analgesic requirements; in view of the prolonged clinical effects of MST, does the use of this formulation

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SummaryTrait anxiety levels (predisposition to anxiety) and personality profiles were recorded in four novice anaesthetists prior to the start of their training in anaesthesia. State anxiety (the extent of anxiety at the moment of testing) was also assessed before and a f e r the transition from accompanied to solo anaesthetic practice. There was no demonstrable difference in anxiety scores as a result of 'going solo' in any subject.

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