A comparison was made between halothane, enflurane and isoflurane with regard to their suitability for minor gynaecological procedures in patients who would be leaving the hospital within 24 h of the anaesthetic. Seventy-five healthy patients were randomly allotted to one of three groups which received one of these anaesthetics. In respect of patient acceptance and postoperative morbidity there were no significant differences between halothane and enflurane, but after isoflurane there was a significantly greater frequency of minor sequelae (headache, nausea, dizziness and coughing) and its pungent odour made it unacceptable to some patients.

A case is reported in which a young man undergoing exploratory thoracotomy following a gunshot wound had a cardiac arrest during reinflation of the collapsed lung. Systemic air embolism was suspected as the cause. Subsequent neurological examination and C.T. scan demonstrated a lesion ascribable to this. Discontinuation of nitrous oxide, aspiration of left heart chambers and a head-down position are recommended as immediate treatment if this diagnosis is made. In cases with piercing lung trauma high inflation pressures should be avoided to prevent embolism.

Epidural morphine was compared with placebo in two randomly selected but similar groups of patients undergoing upper abdominal operations. There was no quantitative or qualitative difference in the analgesia obtained in the two groups of patients but there were significantly diminished long term requirements of intramuscular morphine in those who had been previously given epidural morphine when compared with epidural placebo. The possible causes and implications of this difference are discussed.

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