Anaesthesia
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The author retired from active practice as a consultant anesthetist in the British National Health Service during 1980 at the age of 60. He kept a detailed diary for the last full year as a consultant. One of the editors suggested that the diary, augmented by his considered views culled from the experiences of a professional lifetime, could form the basis of a series of essays on various aspects of the life and practice of a consultant anesthetist during the second half of the twentieth century. This essay considers the special and increasing responsibility of the anaesthetist in the obstetric department, both for the provision of analgesia in the labour ward and anaesthesia for operative obstetrics, and a link between others who are vitally concerned in the provision of safe perinatal care for both mother and child.
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The author's first 300 caudal anaesthetics in children up to the age of 10 years are reviewed. Emphasis is laid upon sedation, both by premedication and by the anaesthetic technique. Nearly all the children were anaesthetised briefly for the sacral injection. ⋯ There was a good correlation between volume of injection per unit of body weight and level of blockade. Dosage can be calculated on this basis for operations on the perineum, lower and groin with 97 to 98% confidence. The volume of solution appeared to be more important than its concentration in determining extent of blockade.