SummarySixty patients who presented for day-case dilatation and curettage were allocated randomly to receive either thiopentone or propofol for induction and maintenance of anaesthesia. One anaesthetist administered all the anaesthetics whilst all assessments were made by one other. The results indicate that early recovery of memory function, critical flicker fusion frequency and subjective feelings of tiredness, drowsiness and alertness were superior in the propofol group. There was a significant difference in subjective feelings of tiredness and drowsiness recorded by the two study groups at 24 hours. Memory function assessed by Wechsler logical memory function passages at 24 hours was impaired in the propofol group in comparison to a group of 'reference' subjects.

Forum 49that found using any other technique and compares favourably with a previous report.I9 The much higher incidence in the females was probably due to the nature of the surgcry. Many of the patients who vomited had done so previously after a conventional technique had been used.Early observations suggested that analgesia following ketamine administration outlasted the period of anaesthesia and that this analgesic effect occurred a t even subanaesthetic doses of ketamine. In this series the mean time from cxtubation to the administration of the first dose of postoperative analgesia was 272 minutes. We do not feel that any conclusions can be drawn from this observation about the duration of the analgesic effect of ketamine. However, only one patient required postoperative analgesia whilst still in the recovery area. This factor must have been significant in the smooth emergence of these patients from anaesthesia.It is unlikely that battle casualties will be prernedicated with papaveretum and hyoscine. Previous expcrience has shown that casualties will receive doses of analgesic on the battlefield and in transit to the field hospital.* At present, the drug that the injured are likely to receive is papaveretum and [hat i s why this drug was chosen as the premedicant. If necessary. supplements of analgesic can be given at the time of induction or during the procedure. Suxamethonium was not used for intubation but when casualties are treated it can be used for a crash induction followed by a loading dose of vecuronium in the normal way.We do not recommend that this technique be adopted to the exclusion of all others in military surgery but we believe that i t can be used to advantage when inhalational agents are not available or are not the most suitable agents. This method is simple, effective, versatile and can be used in combination with other techniques. It is cheap and effective, with air as the carrier gas. Once established, minimum monitoring and minimum interference arc required. In conclusion, we believe that there is a place for total intravenous anaesthesia in the treatment of battle casualties and that the technique that we have described will prove to be significant and safe.

SummaryEighij, d q patients for the vaginal termination of pregnancy were rundomly allocated to receive thiopentone, propofol, methohesironv or etomidate us intravenous induction agents. The same anaesthetist administered the anaesthesia and all the observers were hlind to the agents used. The results show that thiopentone and propofol produced the least sequelae at induction and in recovrrj'. Furthermore, both ugents produced a high quality cf induction and recovery. AN patients were discharged home 2 hours postoiperutivelj~ and there was no obvious delay in recovery. Thii study has altered clinical practice in our Day Surgery Unit.

No abstract