SummaryCorneal abrasion is the most frequent ocular complication to occur during the peri-operative period. This review describes the aetiology of corneal abrasions and evaluates the current methods of prevention. Most abrasions are caused by lagophthalmos (failure of the eyelids to close fully) during general anaesthesia, resulting in corneal drying. General anaesthesia reduces both the production and the stability of tears and therefore increases the incidence of this painful condition. Taping the eyelids closed, soft contact lenses, the instillation of aqueous gels or paraffin-based ointments are all effective in preventing corneal abrasions, but ointments are associated with significant morbidity.

SummaryA case of atypical headache presenting following otherwise unremarkable epidural analgesia in labour is presented. Although there was no suggestion of accidental dural puncture during insertion of the epidural catheter, and despite the unusual features of the headache and complicated case history, an epidural blood patch was performed 13 weeks post-partum, with improvement of the patient's symptoms. A repeat epidural blood patch 2 weeks later completely resolved her headache.

This study compared the analgesic eflectiseness of local injiltration of bupivacaine with caudal extradural bupivacaine in thejirst 48 hours ufter haemorrhoidectomy. Surgical and anaesthetic protocol was rigidly standardised. The caudal group had significantly less pain in the Jirst 6 hours after haemorrhoidectomy. and on jirst bowel opening, when compared to those who received local infiltration of bupivacaine. There was no signi$cant difference between the two groups with respect to further analgesic requirements, complications, time to first bowel action, and duration of hospital stay. The de5nite advantage of caudal extradural bupivacaine.for haemorrhoidectomy must be balanced against the rare but potentially serious complications associated with its use.

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