SummaryIn this study, we evaluated safety and recovery using a patient maintained, target controlled infusion of propofol for sedation in 20 patients undergoing colonoscopy. Using a handset with a two-minute lockout interval, patients could make 0.2 lg.ml )1 increments to an initial target plasma concentration of 1 lg.ml )1 up to a maximum 4.5 lg.ml )1 . Four patients became oversedated but required no airway or circulatory interventions. Subjects had a significant reduction in mean (SD) heart rate: 78.7 (15) vs. 69.8 (13.5) (p < 0.001) and in systolic blood pressure 121.1 (13.2) mmHg vs. 96.5 (8.6) mmHg (p < 0.001). Choice reaction time testing 15 min after colonoscopy showed a significant median (IQR [range]) rise of 162 () 16, 383.3 [-199-859]) ms (p < 0.05). Six patients had faster reaction times postcolonoscopy. All patients denied unpleasant recall and were satisfied with the system. Although oversedation was a problem in this model, we conclude that patient maintained propofol sedation could be possible for colonoscopy.

The case of an 11-year-old boy who suffered second and third degree burns to 78% of his body is reported. The large doses of morphine used as analgesia resulted in severe side effects: ventilatory dependence, impairment of gastrointestinal function and psychological disturbance. Intravenous lignocaine was added without benefit. The addition of low-dose intravenous clonidine, however, precipitated a dramatic reduction in morphine consumption with an attendant improvement in ventilatory, gastrointestinal and psychological functions.

Nous possddons peu de renseignements cliniques sur la gestion anesth~sique d'enfants souffrant du syndrome d'Eisenmenger soumis ~ une chirurgie non cardiaque. Cet article decrit I'expdrience des auteurs qui ont anesth~si~ huit de ces patients pour onze interventions. De ces huit enfants, six avaient un syndrome de Down et une communication auriculoventriculaire, un avait une communication interventriculaire et le dernier, une communication interauriculaire. Neuf des onze interventions dtaient des interventions mineures dentaires, plastiques ou ORL, alors qu'un patient a subi deux laparatomie& On a administr$ ~ trois occasions une pr#mddication (trimdprazine/mdpdridine ou midazolam). L'induction a dt$ rdalis$e avec soit de l~talothane (2) en inhalation, soit par la voie intraveineuse avec du thiopentone (6), de la k~tamine (2) ou du propofol (I). La relaxation musculaire et la ventilation