SummaryA questionnaire study was undertaken to assess the influence of recently published, simple and conclusive research on the practice of anaesthetists in four centres. The research had clearly demonstrated the benefit of subcutaneous infiltration of local anaesthetic in reducing the pain of intravenous cannulation. Of the 81 % who responded, 71 % were aware of the research; 43% of these anaesthetists had altered their clinical practice as a result of the research and 73% used local anaesthesia for cannulae of llgauge or less, compared with only 46% of those who were unaware of the research. Practice comparisons were made between centres andgrades of anaesthetist. Senior house ojicers were sign$cantly less likely to be aware of the research than othergrades. Anomalies were identijied between the apparent awareness of the research and routine practice agreeing with the study findings. The value of research and the incorporation of clinical findings into everyday practice is discussed.

Summary We performed a double‐blind controlled trial to compare the analgesic effect of two nonsteroidal anti‐inflammatory drugs. We compared rectal diclofenac 100 mg given 1 h before induction of anaesthesia with intravenous ketorolac 10 mg given immediately before anaesthesia in 40 patients undergoing arthroscopy of the knee as day cases. A visual analogue scale was used to assess pain prior to discharge. Pain, analgesic consumption, sleep disturbance and restriction of activities were recorded by telephone enquiry 24 h after surgery. There was no difference in the pain parameters, sleep disturbance, or restriction of activity between groups. We suggest that ketorolac 10 mg intravenously and diclofenac 100 mg rectally provide comparable postoperative analgesia in the first 24 h after arthroscopy of the knee.

Good perioperative analgesia following total knee arthroplasty facilitates rehabilitation and may reduce hospital stay. We present the patient analgesic requirements and rehabilitation of a prospective single surgeon series after the introduction of a multimodal drug injection during his total knee arthroplasty. Basic epidemiological data as well as analgesic, antiemetic requirements and time to straight leg raised was collected on 27 consecutive patients (group 1) whom received the multimodal drug injection, consisting of levobupivacaine, ketorolac and adrenaline at the time of their total knee arthroplasty under spinal anaesthesia. Their rehabilitation was compared to a retrospective review of patients who were case matched by age and sex (group 2 (n = 26)), whom had received the unit standard of spinal anaesthetic and a femoral and sciatic block at the time of their operation. Patients in group 1 had significantly lower analgesic and antiemetic requirements than group 2. Group 1 also had a significantly shorter hospital stay. We have demonstrated that periarticular multimodal drug injection can improve perioperative analgesia and mobilisation following total knee arthroplasty as well as reducing opioid requirements and side effects.

SummaryA double-blind placebo-controlled study was performed to assess the analgesic effect of rectal sodium diclofenac lOOmg after Caesarean section using subarachnoid hyperbaric bupivacaine 0.5% and morphine 0.2 mg. During the 48 h follow-up period, both placebo and diclofenac groups had comparable analgesia as measured by visual analogue scores P A S ) at rest and on movement. However, diclofenac prolonged the mean time t o j r s t analgesia by more than 5 h from 13 h 45min in the placebo group to 18h 58min @ < 0.03). The incidence of side effects (nausea, vomiting, itching, excessive lochia loss and the need for additional analgesia) were comparable in each group.