Fifty-seven patients with penetrating cardiac or pericardial trauma were treated at the Department of Cardio-Thoracic Surgery, University of Stellenbosch at the Tygerberg Hospital during a 6 1/2 year period from June 1971 to January 1978. Eleven patients were treated by aspiration alone because tamponade was mild, or because they were seen between 24 hours and 3 weeks after injury. Six patients underwent late elective surgery. Cardiopulmonary bypass had to be employed in four patients to correct intracardiac lesions. All other patients underwent emergency operations 8 minutes to 2 hours after admission to hospital. The hospital mortality was 4 of 57 patients (7%), lower than rates reported in other series. Some selected cases will be described more fully and our present plan of management is outlined.

The long‐acting local anaesthetics bupivacaine and etidocaine were compared in a double‐blind study using ulnar nerve block. Eleven volunteers took part in the study. Solutions used were: bupivacaine 0.25 % and 0.5 % and etidocaine 0.5 % and 1 %. All solutions contained adrenaline 5 μg/ml. The time of onset and duration of analgesia and motor block, degree of motor block, and changes in skin temperature were investigated. The results did not show any differences in the duration of sensory of motor block. Differences were seen in the degree of motor block in favour of etidocaine. The sympathetic block seemed to be more intense and of longer duration with bupivacaine. Etidocaine had a shorter time of onset in all nerve fibres. ZUSAMMENFASSUNG Die beiden langwirkenden Lokalanaesthetika Bupivacain und Etidocain wurden in ihrer Wirkung miteinander verglichen. 11 freiwillige Versuchspersonen erhielten jeweils vier Ulnarisblockaden mit Bupivacain 0,25 % und 0,5 % sowie mit Etidocain 0,5 % und 1 %. Allen Lüsungen war Adrenalin in der Konzentration 5 μg/ml zugemischt. Es wurden untersucht: die Latenz‐ und Wirkungszeit der Analgesie, die Latenzzeit, die Wirkungszeit und der Grad der Motorblockade und der Grad und die Dauer der Sympathicus‐blockade (Hauttemperaturerhöhung). Beide Lokalanaesthetika zeigten in den geprüften Konzentrationen keine grossen Unterschiede in der Wirkungszeit für die Analgesie und die motorische Blockade. Unterschiede ergaben sich im Grad der Motorblockade zu Gunsten von Etidocain und in der Blockade der Cfasern (Sympathicus, Temperaturerhöhung) zu Gunsten von Bupivacain. Etidocain wies bei allen gepriiften Parametern eine kurzere Latenzzeit auf als Bupivacain.