or alteration in the levels of consciousness. These levels returned to baseline within 24-72 hours after the dose of epidural morphine. The tracheas of six patients were extubated when the patients satisfied other extubation criteria despite elevated Pcoz levels.In our study, epidural morphine provided adequate analgesia with significantly less haemodynamic disturbance and minimal incidence of ileus when compared to intravenous morphine. One-third of the intravenous morphine group had adequate analgesia and sedation. Epidural morphine is superior to intravenous morphine for analgesia in patients with compromised cardiac or pulmonary status and who require postoperative controlled ventilation. University of

SummaryThe death under general anaesthesia of a child with Adriamycin cardiomyopathy is reported. The acute, subacute and chronic cardiotoxic effects of Adriamycin are discussed and the risk factors for chronic Adriarnycin cardiomyopathy presented, with particular reference to cumulative dosage of Adriamycin. The insidious onset of impairment of cardiac function is stressed and suggestion3 for anaesthetic management outlined