Anaesthesia
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Hypotension was induced with halothane and labetalol, an alpha and beta adrenergic blocking agent, in nine children undergoing operation for postductal coarctation of the aorta. The mean arterial pressure decreased by an average of 30% following labetalol, and in six patients the initial halothane concentration (1%) had to be reduced during this period. ⋯ Profound beta-blockade did not occur, and operating conditions were considered satisfactory. The usefulness of labetalol in the postoperative period is suggested.
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Case Reports
Ablation of the brachial plexus. Control of intractable pain, due to a pathological fracture of the humerus.
A case report is presented which illustrates the difficulties in providing control of intractable pain from pathological fractures of the humerus. Relief from large and frequent doses of systemic analgesics was found to be inadequate. Control was achieved using brachial plexus block with bupivacaine combined with absolute alcohol. The decision to partially ablate the plexus is considered to be justified by the improved quality of life which the patient enjoyed.
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Multiple choice questions have been used to assess the progress of 105 postgraduate anaesthetic students over three successive academic years, at the University of Liverpool. Analysis of the results of these tests had revealed a good correlation existing between the MCQ scores obtained and success or failure in the Colleges' Primary FFARCS examinations. ⋯ The value of serial MCQ tests is discussed in relation to encouraging and discouraging students in sitting postgraduate examinations. Analyses of these tests are also of value in planning teaching programmes, assessment of teaching and predicting overall successes and failure of students.
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Seven hundred and twenty-two patients who received epidural analgesia during labour were delivered by Caesarean section. The block was extended in 554 patients to provide analgesia for surgery. ⋯ The main complications were maternal hypotension (15.9%) and vomiting (17.1%). Almost all patients expressed enthusiasm for the technique.