Anaesthesia
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This study compared the spread of 3 ml of a solution of bupivacaine-methylene blue in the intercostal space of patients and cadavers. There were 51 successful injections in each group which demonstrated in 86% of patient injections and 84% of cadaver injections that spread was confined to one intercostal space. Spread was more extensive in cadavers, probably as a result of autolysis. It would therefore still appear necessary, when low volumes of local anaesthetic are used, to block each intercostal nerve individually.
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A new tracheal tube which incorporates a movable bronchus blocker (the Univent tube), was evaluated in eight patients who underwent thoracic surgery. Difficulties encountered with accurate placement suggest that routine use should be made of a fibreoptic bronchoscope to confirm the position of the blocker.
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Letter Case Reports
Hazard of continuous epidural infusion of local anaesthetic.