Anaesthesia
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Entrainment of air following exploration of posterior cranial fossa in the sitting position was studied in five patients. Intracranial pressure was monitored through a ventriculostomy catheter after closure of the dura. In three patients nitrous oxide was added to the breathing mixture only after the baseline intracranial pressure had stabilised following closure of the dura. ⋯ Two patients were nitrous oxide from the beginning. No change in intracranial pressure was noted. Computerised tomogram on the first postoperative day revealed a significant amount of air in eight cases.
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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.