In this study, the best nutritional factor for detecting the risk of MC is albumin levels below 30 g/l. A weight loss greater than 15% is required to obtain a statistically significant correlation with the existence of MC.

Proponents of acupuncture anaesthesia have tended to look on it as a replacement for conventional anaesthesia. This randomised, controlled trial involving 250 cancer patients undergoing abdominal or pelvic surgery, has aimed to assess the use of electroacupuncture as the sole analgesic, but within a standard anaesthetic. It was found that while there was little difference between the per-operative requirement for anaesthetic drugs, all the non acupuncture group required fentanyl, compared to only 5% of the electroacupuncture group (P<0.001). Time to spontaneous respiration (P<0.02) and extubation (P<0.001) immediately post-operatively was reduced in the acupuncture group. Transcutaneous electrical nerve stimulation (TENS) was used for post-operative pain relief in the acupuncture group, while the control group received non-narcotic analgesics. There was no significant difference in the numbers of patients complaining of pain, but the requirement for additional analgesia was less when TENS was used (P<0.01). There was no difference in the period of post-operative ileus as measured by the return of normal bowel sounds. However the return to normal self caring was significantly improved in the acupuncture group (P<0.02). Both practically and economically this is probably the most important beneficial aspect of electroacupuncture demonstrated by this study.

CORRESPONDENCE 271 mmHg.) In addition, dissolved carbon dioxide accounts for only about five per cent of the total carbon dioxide in the venous blood, s Therefore it seems unlikely that any carbon dioxide bubbles would remain in the circulation more than two hours after the embolism occurred, the time when the patient described underwent HBO. On balance I feel that the hazards associated with the transport of a critically ill patient outweigh the questionable benefits of HBO following carbon dioxide gas embolism.

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