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Cyanosig it a sign for which the anaesthetist must be alert. Intraoperative eyanosis requires rapid and definitive diagnostic manoeuvres to rule out hypoxaemia prior to considering more exotic causes. The following case illustrates the course of such an investigation. Case reportA 15-year-old boy from France, while attending an international church conference, developed periumbilieal pain. After 48 hours the pain localized to the right lower quadrant and he was taken late at night to the emergency department. A diagnosis of appendicitis was made. Intravenous fluids were started and he was given metronidazole 5(~0 rag, tobmmycin 60 rag, meperidine 50 mg and dimenhydrinate 50 rag.The patient gave a history of essential hypertension and

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