During operations for thoracoabdominal aneurysms, monitoring of motor-evoked potentials is an effective technique to detect spinal cord ischemia within minutes. This modality can be used to guide the management of distal aortic perfusion techniques and may also help to identify segmental arteries that need to be reattached.

SummaryWe studied the repeated effect of sterilisation on light intensity in laryngoscopes from Penlon, Riester, Heine (two different blades), Medicon and Upsher. Light intensity was measured by a light meter using two methods. Measurements were performed before the decontamination procedure was carried out and subsequently after each series of 25 procedures until a total of 200 cycles was reached. Using method 1 (and 2), the reduction in light intensity after 200 cycles was 100% (100%; no light emitted), 37% (13%), 75% (69%), 79% (60%), 37% (14%) and 63% (55%) for each blade, respectively. Keywords Equipment; laryngoscopes. Infection control; sterilisation. disinfection. Larynx; laryngoscopy. To prevent infection, decontamination of laryngoscopes is of vital importance, especially in the immunocompromised patient. Although decontamination should start with rigorous mechanical cleaning [1], machine washing being the most effective method, controversy exists as to whether this should be followed by highlevel disinfection or sterilisation [1±3]. Recently, this discussion became particularly relevant when Control of Substances Hazardous to Health (COSHH) regulations applicable throughout the EC made many disinfection agents (e.g. glutaraldehyde solutions) no longer easily accessible. In this respect it is disturbing that alcohol, a frequently used alternative, is not considered to be a high-level disinfectant [1]. There is a high incidence of noncompliance with current guidelines [4,5] and the result of any decontamination protocol relies on consistent adherence [3,6]. These problems can be overcome with the use of sterilisation.However, one of the potential disadvantages of steam sterilisation at 134 8C is that it might be detrimental to ®brelight blades. We are unaware of data describing the effect of steam sterilisation on the ®brelight laryngoscope blades currently on the market. We therefore undertook this study to evaluate the effect of automated machine washing and subsequent steam sterilisation at 134 8C on various ®brelight laryngoscope blades and handles, focusing on the effect on light intensity provided by the blades. Methods

Retrograde aortic and selective organ perfusion is a safe technique and can prevent ischaemic renal and intestinal damage during cross-clamping of the aorta in thoracoabdominal aneurysm surgery.

Forced-air blankets reduce afterdrop. However, they do not lead to clinical relevant changes in deep thigh temperature. LDF measurements show that forced-air heating does not improve toe perfusion. The extra heat especially favours core temperature. This is underlined by the decrease in postoperative leg blood flow, suggesting that the majority of the warmed blood leaving the heart flows to core organs and not to the periphery.