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ABSTRACT:The purpose of this article is to discuss various factors associated with successful handling of mass casualties in the field with special reference to the airborne military operations. Various limitations specific to airborne operations are highlighted. Stress is laid on the importance of variables as they effect medical support and planning. Various analgesics, both opiates and non opiates including role of subanaesthetic doses of ketamine are discussed. Adequate knowledge and experience in wide ranging field techniques including improvisations is stressed. The facts are placed in a specific, original context through which new insight can be derived. The feasibility of incorporating light weight modem equipments in field anaesthesia are also brought out.MJAFlI999; SS : 237-241

The most commonly used technique in routine spinal anaesthesia practke is the midline approach. compared to the lateral or paramedian approach. With the better understanding of the technique and introduction of fine gauge spinal needles. this practice needs a rethinking. Lateral approach was used in 60 patients undergoing different surgical procedures below the umbilicus, using 24 or 25 gauge, Quincke spinal needle without an introducer. The result was gratifying. In 77% of the cases the subarachnoid space could be entered in the first attempt. There was no failure. No patient complained of postdural puncture headache or post operative backache. Only one patient reported paraesthesia during needle placement without any residual effect. Various other advantages of the technique are discussed. Thus with due practice, lateral approach is found to be superior in modern day spinal anaesthesia.

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