The internal transverse, outer transverse and antero-posterior diameters, length of trachea and bronchi and circumference of trachea, relate in a linear fashion to CRL and age. However, subcarinal and bronchial angles remained constant.

References1. Beach PS, Beach RE, Smith LR. Hyponatraemic seizures in a child treated with desmopressin to control enuresis. Clin Pediatr 1992; 31: 566-569. 2. Yaouyanc G, Jonville AP, Yaouyanc-Lapalle H et al. Seizure with hyponatremia in a child prescribed desmopressin for nocturnal enuresis. Clin Toxicol 1992; 30: 637-641. 3. Kallio J, Rautava P, Huupponen R et al. Severe hyponatremia caused by intranasal desmopressin for nocturnal enuresis. Acta Paediatr 1993; 82: 881-882. 4. Schwab M, Wenzel D, Ruder H. Hyponatraemia and cerebral convulsion due to short term DDAVP therapy for control of enuresis nocturna. Eur J Pediatr 1996; 155: 46-48. 5. Donoghue MB, Latimer ME, Pillsbury HL et al. Hyponatremic seizure in a child using desmopressin for nocturnal enuresis. Arch Pediatr Adolesc Med 1998; 152: 290-292. 6. Apakama DC, Bleetman A. Hyponatraemic convulsion secondary to desmopressin treatment for primary enuresis. J Accid Emerg Med 1999; 16: 229-230. 7. Bernstein SA, Williford SL. Intranasal desmopressinassociated hyponatremia: a case report and literature review. J Fam Pract 1997; 44: 203-208. 8. Odeh M, Oliven A. Coma and seizures due to severe hyponatremia and water intoxication in an adult with intranasal desmopressin therapy for nocturnal enuresis. J Clin Pharmacol 2001; 41: 582-584. 9. Shindel A, Tobin G, Klutke C. Hyponatremia associated with desmopressin for the treatment of nocturnal polyuria. Urology 2002; 60: 344. 10. Weatherall M. The risk of hyponatremia in older adults using desmopressin for nocturia: a systematic review and meta-analysis. Neurourol Urodyn 2004; 23: 302-305. 11. Lose G, Mattiasson A, Walter S et al. Clinical experiences with desmopressin for long-term treatment of nocturia. EDITOR:The use of regional anaesthesia in patients with a recognized difficult airway does not solve the problem of difficult airway; the difficult airway is still present. We report a case where giving regional anaesthesia in a patient with difficult airway, required emergency securing of the airway. A 58-yr-old male patient (55 kg, 160 cm, ASA II) suffering from ankylosing spondylitis for 25 yr was scheduled for total hip replacement. Airway examination revealed interincisor distance of 4 cm, normal dentition, and reduced mentosternal distance of 6 cm due to fixed flexion deformity of neck. X-ray revealed ankylosis of spinous processes showing posterior joint involvement, resorption of the anterior surfaces of the vertebral bodies and ossification of the posterior ligaments and surrounding soft tissues. Anaesthesia was planned with a combined spinal epidural (CSE), separate needle technique, with difficult intubation cart ready. Premedication consisted of diazepam 10 mg orally the previous night and oral ranitidine 150 mg with metoclopramide 10 mg 2 h before surgery. On arrival in the operating room, routine monitoring was applied and an intravenous (i.v.) line was secured. The epidural block was attempted by the para-median approach through L 3-4 space with the patient in the sitting position but the space coul...

The addition of 1 mug.kg(-1) IT fentanyl to spinal bupivacaine prolonged the duration of spinal block in infants undergoing lower abdominal and urologic procedures.

We conclude that when intraarticular midazolam was compared with placebo there was a reduction in pain after day-case arthroscopic knee surgery; however, this pain relief was of relatively short duration.

A low dose of midazolam and ketamine with bupivacaine intrathecally results in prolonged analgesia and less haemodynamic fluctuations. However, the safety of this combination needs to be proved before its use in clinical practice.