No abstract

The specific use of ECT to control homicidal impulses in a pregnant, acutely psychotic schizophrenic patient is described, with no adverse effects to the mother or the baby. Besides the relative safety of the procedure during pregnancy, the need for monitoring foetal effects is stressed. Although literature is abundant on various aspects of ECT (1-3) there has been little written on its use in pregnancy (4-6) for its value in treating severe depressive illness or certain types of schizophrenia; without adverse effect to the mother and the baby, and where there is a risk-benefit advantage to its use. Nineteen hundred and eighty-four marked 50 years in the history of the use of convulsive therapy (Metrazol) since its introduction into the realm of psychiatry by the Hungarian psychiatrist, Ladislas Meduna. Electro-convulsive therapy (ECT) has been the subject of much controversy among the lay public and some professionals alike in recent years, even though it is generally considered to be one of the most effective treatments available in psychiatry. The Canadian Psychiatric Association (7), the American Psychiatric Association (8), and the Royal College of Psychiatrists (U.K.) (9) have made their position clear on the issue. In a recent Canadian survey of the use of ECT, Smith concluded, "Some of the reported rates are below the predicted minimum levels" indicating that "certain patients have been deprived of the most effective treatment available" (10).

No abstract

The intrathecal administration of amethocaine plus morphine as an anaesthetic technique for providing surgical anaesthesia and postoperative analgesia was evaluated in 24 patients undergoing transurethral resection of the prostate. The efficacy of the technique was compared with that observed following spinal anaesthesia with amethocaine alone. Twelve patients (group I) received spinal anaesthesia with amethocaine 12-14 mg and a further 12 patients (group II) received spinal anaesthesia with amethocaine 12-14 mg plus morphine 1 mg. In group II the addition of morphine 1 mg to the amethocaine produced excellent surgical anaesthesia and postoperative analgesia and these patients had significantly less postoperative pain than the patients who received amethocaine alone. There was a high frequency of side-effects associated with intrathecal morphine in group II, for example, subtle respiratory depression, nausea, vomiting and pruritus.