The effectiveness of fentanyl, given as part of the anaesthetic technique, in reducing abdominal pain following outpatient gynaecological surgery has been examined. It was found to reduce significantly the frequency of abdominal pain in the period extending from discharge from hospital to the first evening, while not compromising surgical conditions nor increasing the frequency of other post-operative sequelae such as nausea and vomiting.

A novel carrier solution, icodextrin 20 (7.5%) has allowed exploration of prolonged intraperitoneal (IP) infusion of the cytotoxic drug, 5-fluorouracil. Eighteen patients with intraperitoneal carcinomatosis were entered into a feasibility and pharmacokinetic study of prolonged regional (IP) chemotherapy.. Specialist nurses trained the patients to self-administer their own treatment via a permanent i.p. catheter. A twin bag delivery system was used to perform one exchange daily. It proved possible to deliver continuous (5 days per week) i.p. 5-fluorouracil at doses of 200 mg/m2 and 300 mg/m2 for up to 12 weeks. The toxicities seen were infective peritonitis, nausea and vomiting, lethargy and anorexia. This was a nurse-led study and the home-based therapy holds promise for patients with malignant peritoneal disease.

To compare two anaesthetic techniques, morbidity following day-case gynaecological surgery in 170 patients was assessed by means of a questionnaire at the time of leaving hospital. A further questionnaire sought information for the evening of the operation, and the 1st and 2nd days after operation. Ninety-four per cent of patients returned the latter questionnaire. There was a high frequency of morbidity extending into the 2nd day after operation. An anaesthetic technique using Althesin and nitrous oxide in oxygen offered no advantage over a technique with thiopentone and nitrous oxide in oxygen and halothane.

In 105 patients undergoing day-case surgery recovery of consciousness was significantly faster after enfluane compared with halothane anaesthesia. There was no difference in postoperative morbidity between the two anaesthetic groups.

Summary In 103 women admitted for out‐patient vaginal terminations of pregnancy, the relation was investigated between the use of ecbolics and blood loss, vomiting and other side effects. Patient self‐rating was incorporated in the study for comparative purposes. Use of a combined preparation of oxytocin and ergometrine resulted in the lowest blood losses. Ergometrine administered alone was associated with immediate nausea and vomiting but no delayed effects. Seven days after abortion, 35% of the women were still complaining of vaginal bleeding, although in most the volume was low.