The classical stimulants amphetamine, methamphetamine, ethylamphetamine and the amphetamine-derived designer drugs MDA, MDMA ('ecstasy'), MDEA, BDB and MBDB have been widely abused for a relatively long time. In recent years, a number of newer designer drugs have entered the illicit drug market. 4-Methylthioamphetamine (MTA), p-methoxyamphetamine (PMA) and p-methoxymethamphetamine (PMMA) are also derived from amphetamine. Other designer drugs are derived from piperazine, such as benzylpiperazine (BZP), methylenedioxybenzylpiperazine (MDBP), trifluoromethylphenylpiperazine (TFMPP), m-chlorophenylpiperazine (mCPP) and p-methoxyphenylpiperazine (MeOPP). A number of severe or even fatal intoxications involving these newer substances, especially PMA, have been reported. This paper describes a method for screening for and simultaneous quantification of the above-mentioned compounds and the metabolites p-hydroxyamphetamine and p-hydroxymethamphetamine (pholedrine) in human blood plasma. The analytes were analyzed by gas chromatography/mass spectrometry in the selected-ion monitoring mode after mixed-mode solid-phase extraction (HCX) and derivatization with heptafluorobutyric anhydride. The method was fully validated according to international guidelines. It was linear from 5 to 1000 micro g l(-1) for all analytes. Data for accuracy and precision were within required limits with the exception of those for MDBP. The limit of quantification was 5 micro g l(-1) for all analytes. The applicability of the assay was proven by analysis of authentic plasma samples and of a certified reference sample. This procedure should also be suitable for confirmation of immunoassay results positive for amphetamines and/or designer drugs of the ecstasy type.

Paediatric obstructive sleep apnoea (OSA) is characterised by stertor, intermittent oxygen desaturation and repeated nocturnal awakening. 1 If left untreated, it can have significant repercussions, such as cor pulmonale, growth and developmental delay. 2 Adenotonsillectomy has proven to be effective in improving OSA outcomes in the majority of children. 3 Tonsillectomy (with or without adenoidectomy) is the most frequent ENT procedure comprising of 17% of the workload in the UK. 4 There has been an effort in recent years to improve day case surgery rates for these patients and to ensure safe delivery of services at secondary and tertiary centres within the UK for children with OSA. 5 Improvements in patient care will therefore have a widereaching impact on children and their families. Knowledge of post-operative complication rates for childrenwith OSA undergoing adenotonsillectomy is essential to be able to deliver safe and appropriate care and to support informed consent and shared decision-making. Age and comorbidities have been investigated to varying degrees to determine whether day case surgery and surgical delivery in secondary care centres are safe. [6][7][8] Since 2015, our paediatric tertiary centre has undergone a 3-stage service improvement process aimed at improving the safety of day case adenotonsillectomy for paediatric patients with OSA. We present our data and outcomes from our tertiary centre experience which has been used to help create the national strategy, released in 2019, for managing paediatric patients with OSA undergoing adenotonsillectomy.

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