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In four groups of 10 patients, 0.5% bupivacaine 5 ml was used in spinal anaesthesia for gynaecological surgery. Group 1 received plain solution in the sitting position, group 2 plain solution in the lateral position, group 3 hyperbaric solution in the sitting position and group 4 hyperbaric solution in the lateral position. All patients were returned to the horizontal supine position, the sitting subjects 2 min after, and the lateral subjects immediately after, spinal injection. In each group the mean height of block was to the mid-thoracic segments, but there was no significant difference between the groups. There was, however, considerable scatter within each group. Posture had some effect on the speed of onset of the analgesia, but no significant effect on the final outcome. The use of 0.5% bupivacaine as a test dose in extradural blockade is discussed.

The catecholamine and cardiovascular responses to laryngoscopy and tracheal intubation were studied in 20 patients who u n r k m w ! elective gynaecological surgery and ivho were allocated randoml-v to receive either practolol I0 mg or saline in travewously

Measurement were made of gastric pressure (GP), lower oesophageal sphincter pressure (LOSP) and barrier pressure (BrP) in the supine and lithotomy positions in 17 healthy women undergoing termination of pregnancy in the first trimester. Values in the supine position were similar to those seen in non-pregnant subjects, but there was a significant reduction in LOSP and BrP in the lithotomy position unrelated to any change in intragastric pressure. It is concluded that the lithotomy position is associated with increased risk of regurgitation in early pregnancy.

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