INTRAVENOUS ANAESTHESIA IN OBSTETRICS para, was delivered of a breech with legs extended, a leg having to be brought down. The child did very well, and the mother suffered no undue shock. In 3 cases persistent occipito-posterior positions have been manually rotated and delivery made with forceps, without undue hurry being experienced, and neither mother nor child appeared to suffer in any way.In 6 cases the bead was found to be unexpectedly "tight," and considerable traction was required to deliver the child. In 4 of these a perineal tear resulted, but this was repaired without any additional anaesthetic.Evipan has been given, in rather smaller dose, to 7 patients just before the birth of the head, when forceps N-ere not used. In one case trouble was experienced with the child after delivery-there being some delay in respiration. In the other 6 cases the children cried at once and there were no neonatal complications. In no case was there any excessive post-partum bleeding, and the placenta always appeared to separate quickly and easily. Description of TechniqueThe technique which is now adopted has been modified with increasing experience, and I hope that the following brief description may be of value to others.Having decided to deliver the patient, she is placed in the left lateral positioil and obstetric aid straps are applied.The type used has been that described by C. J. Penny (1933): one strap encircles the abdomen and is affixed to the head of the bed; the other holds the patient's hips flexed and passes over her neck. The buttocks and perineum are then thoroughly swabbed with dettol cream, and a swab covered liberally with dettol cream is left in the vagina.The operator, gowned and masked and with bare washed hands, is now ready to administer the evipan. A prop is placed between the patient's jaws, and the nurse, standing by her head, helps in steadying the arm: a firm grip above the elbow will make the veins in the antecubital fossa more obvious. In every case 10 c.cm. of the 10% solution of evipan has been used. The first 3 or 4 c.cm. is injected quite quicklv, and after a pause the remainder of the dose is given rather more leisurely -about a minute being taken over the whole procedure. In all my cases I have had the help of only the nurse or midwife; she remains at the patient's head, holding the chin well forward, and from the same position she is able later to support the patient's right leg by faking hold of the strap.The operator now re-washes his hands and dons sterile gloves. The dettol cream swab is extracted from the vagina and is used for one last application to perineum and buttocks. Sterile towels are then used to cover exposed areas, after which a catheter is passed, the receiver being held by the nurse, who has it ready beside her. At this stage the forceps are applied to the child's head and the extraction is carried out in the ordinary wav. When there has been the need for earlier sedation by chloral and.bromide, or morphine, a very complete anaesthesia has been experienced, with a pa...

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