SummaryThis is a report of a modification of the standard Macintosh laryngoscope blad? to facilitate tracheal tube placement in cases of' dificult visualisation of the larynx. The modification oflers the unique advantage, of a hinged blade tip, controlled by a lever on the handle of the larygoscope which allows elevation of the epiglottis while decreasing the overall laryngoscopic elevation or levering movement required. It is an adaptation which can be applied to most laryngoscope blades, does not require any special training in its use and will prove useful for both routine intubations as well as those which may be dificult and associated with an anterior larynx.
The frequency and nature of the oculocardiac reflex and its prevention by atropine or giycopyrrolate (i.m. and l v) have been studied in 160 children undergoing surgery for the correction of squint. Ninety per cent of those given no anticholinergic premedication exhibited the reflex. This was decreased to about 50% in those receiving the drugs i.m. Giycopyrrolate 7.5ngkg~' and atropine 15ngkg~' i v. were effective in most instances, the latter being slightly better However, giycopyrrolate was associated with tachycardia of smaller magnitude. The reflex was observed more often following traction on the medial rectus muscle.
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