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The impact of early retirement on medical workforce supply may be considerable. Approaches to retirement policy need to shift away from the extremes of either full-time employment or total retirement.

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IN 1902 Campiche, of Lausanne, observed that chest complications are likely to occur after "operations an effect of which is to cause pain on coughing. .. and to upset expectoration and the free functioning of the abdominal pressure". Lawen, in 1912, further remarked: "if we were in a position to produce prolonged anaesthesia, lasting for several days, it is likely that the incidence of bronchitis and pneumonia following laparotomy would be decisively reduced". § Since this time it has become widely recognized that of all operations those within the abdomen, and particularly the upper abdomen, are most likely to be followed by severe pain and respiratory disturbance (

of the anti-inflammatory agent voltaren. Scandinavian Journal of Rheumatology 1978; 7 (Suppl. 22): 17-29. 16. CRAIG DB. Postoperative recovery of pulmonary function. Anesthesia and Analgesia 1981; 6 0 4652. 17. TIGERSTEDT I, JANHUNEN L, TAMMISTO T. Efficacy of diclofenac in a single prophylactic dose in postoperative pain.Two techniques of total intravenous anaesthesia for laparoscopy were compared in 80 patients . Group 1 received alfentanil, propofol and vecuronium, and Group 2 alfentanil, midazolam, ketamine and vecuronium. Haemodynamic stability after induction and the pressor response to tracheal intubation were sign$cantly different. There was no signij?cant difference in recovery times between the two groups and little difference in other postoperative sequelae.