Front Matter (PDF) - BJA

p
*«' Lib,
Volume 47.No. 5 May 1975

Ken Crowe
is fed up
with r
Portex!
.... and you can't really blame him. As a (relatively) tame photographer he's
kept pretty busy with Portex work. You've probably seen his photographs
in the leading medical press already, featuring Portex products.
The trouble is, he says we're putting him out of business. We wanted to do
an advertisement featuring just a selection from our enormous anaesthetic
range items such as the Softseal Endotracheal and Tracheostomy Tubes,
the new Blue Line Ivory Vinyl Endotracheal Tubes, Suction Catheters with
control valves, P.V.C. Airways, Connectors, Adaptors and the Thermal
Humidifying Filter. It was there we had to stop - it was either a multi-page
advertisement or no work this time Ken.
Never mind Ken, if they want to see your work (and Portex's of course)
they can always send for the new Portex brochure containing the full range
of anaesthetic products.
PORTEX
The perfect system
Portex Ltd., Hythe, Kent. CT21 6JL.
Telephone: Hythe (0303) 66863 or 60551.
Telex: 96165. Cables: Portex Hythe Telex
Also in U.S.A. and Canada

1 ii respiratory therapy, intensive care and anaesthesia there are
three good reasons for preferring the new Philips ventilators:-
Hosp
Lih
1. Flexibility of breathing patterns.
2. Ease of sterilisation.
3. Choice of configuration.
TheJWI ventilator can be adapted
to cope with every clinical condition.
The AV1 ventilator, for adult and
paediatric use, is a newly developed
breathing machine. It is a time-cycled
minute volume divider tor anaesthesia,
intensive care and respiratory therapy.
The compressible volume is negligible
(particularly important in paediatrics);
the upper airway pressure can be as
high as 100 cm H ,O; the expired gases
can be piped away so as not to
contaminate the room air, the entire
expiratory circuit and patient system
can be exchanged for another in a
matter of seconds so that periodic autodaving
does not interrupt ventilation.
The flowrate and the duration of both
Medical
Systems
inspiration and expiration can be independently
adjusted over a range wide
enough to meet every clinical condition.
Alternative/additional modules tor
the AVI provide:-
-PEEP
-sub-atmospheric(negative phase)
expiration.
-100% humidification with close
control of air temperature at the
patients' mouth.
-Meter indication with adjustable
upper and lower alarm levels tor
pressure and expiratory volume
with interfaces for connecting
both recorders and oscilloscopes.
The whole system tits standard 19*
racking and is compatible with Philips
modular patient monitoring equipment.
Safety. A lock prevents the expiration
phase becoming shorter than the
inspiration phase. All pressures,
negative and positive, are limited to
safe values by relief valves. I n the event
of a power failure inspiration and
expiration valves open so that a patient
with any ability to breath can do so.
For more details contact-
Philips Medical Systems Ltd.,
Medical Electronics Division,
45, Nightingale Lane,
LONDON SW128SX.
PHILIPS

EDITORIAL BOARD
Editor of General Issues
A. A. SPENCE, Senior Lecturer, University Department of Anaesthesia (Western Infirmary),
Glasgow
Editor of Postgraduate Educational Issues
R. A. MILLAR, Professor of Anaesthesia, University Department of Anaesthesia, Glasgow
Royal Infirmary
G. H. BUSH, Consultant Anaesthetist, Alder Hey Children's Hospital, Liverpool
C. M. CONWAY, Consultant Anaesthetist, Westminster Hospital, London
E. A. COOPER, Professor of Anaesthesia, University of Newcastle upon Tyne; Honorary
Consultant Anaesthetist, Newcastle University Hospitals
J. W. DUNDEE, Professor of Anaesthesia, Queen's University of Belfast
W. FITCH (Assistant Editor), Institute of Neurological Sciences, Glasgow
T. CECIL GRAY, Professor of Anaesthesia, Dean of the Medical School, University of
Liverpool
A. R. HUNTER (Hon. Treasurer), Reader in Anaesthesia, University of Manchester
D. G. McDowALL, Professor of Anaesthesia, University of Leeds
W. W. MUSHIN, OB.E., Professor of Anaesthetics, Welsh National School of Medicine
J. F. NUNN, Head of Division of Anaesthesia, Clinical Research Centre, Harrow;
Honorary Consultant Anaesthetist, Northwick Park Hospital
J. B. OWEN-THOMAS, Senior Lecturer in Paediatric Respiratory Studies, University of
Liverpool
J. P. PAYNE, British Oxygen Research Professor of Anaesthetics, Royal College of
Surgeons of England
J. E. RIDING, Consultant Anaesthetist, United Liverpool Hospitals; Demonstrator in
the Department of Anaesthesia, University of Liverpool
J. G. ROBSON, Professor of Anaesthetics, University of London, Royal Postgraduate
Medical School
D. B. SCOTT, Consultant Anaesthetist, Royal Infirmary, Edinburgh
W. D. WYLIB, Consultant Anaesthetist, St. Thomas's Hospital, London
Assistant Editors
W. G. ANDERSON, University Department of Anaesthesia (Royal Infirmary), Glasgow
G. SMITH, University Department of Anaesthesia (Western Infirmary), Glasgow
Papers for publication and all editorial communications should be addressed to the
Editor, University of Glasgow, Department of Anaesthesia (Western Infirmary), 4 lilybank
Gardens, Glasgow G12 8RZ; business communications to the publishers: Macmillan
Journals Ltd., 4 Little Essex Street, London WC2R 3LF.
The GUIDE TO CONTRIBUTORS can be found on pages 9-11 of the advertisement section
of the January issue.
Published monthly. Annual subscriptions: UJC and Eire £10.50; USA and Canada
£12.50; Rest of the World £12.50. Payment may be made in any currency at the current
exchange rate. Orders must be accompanied by remittance. Prices applicable only to
subscriptions started before December 31, 1975. Cheques should be made payable to
Macmillan Journals Ltd: Subscription Department, Brunei Road, Basingstoke, Hampshire
RG21 2XS, England.
Second Class Postage Paid New York, N.Y. U.S. Mailing Agent: Air and Sea
Freight Inc., PO Box 1305, Long Island City, N.Y. 11101.
All enquiries concerning advertising should be addressed to
Advertisement Department, Macmillan Journals Ltd., 4 Little Essex Street, London
WC2R 3LF. (Telephone 01-836 6633)

The
mechanism of
post-prostatectomy bleeding
and
EPSIKAPRON
control
Epsikapron (aminocaproic acid) is
rapidly excreted in the urine in high
concentration; there it inhibits
urokinase, the ifibrinolytic enzyme in
urine. With the haemorrhage-sustaining
property of urine blocked, the
haemostatic coagulum becomes
adequate, and blood loss is diminished
substantially.
Presentation
URINE
containing
UROKiNASE
Epsikapron makes your prostatectomy
patient's post-operative course
smoother by diminishing:
the need for post-operative blood
transfusion
clot retention
catheterization
the risk of infection
the period of hospitalization
Epsikapron Solution for Injection 0.4 g/ml Box of 6 ampoules of 10 ml, each containing 4.0g
aminocaproic acid (0022/5003) Epsikapron Effervescent Powder 50% Box of 30 sachets,
each containing 3.0g aminocaproic acid (0022/5004) Epsikapron Syrup 0.3g/ml Bottle of
250ml (0022/5005)
EPSIKAPRON 9
Manufacturer: AB Kabi, Stockholm, Sweden.
Further information from:
KabiVltrum Ltd
Bilton House, Uxbridge Road, Ealing, London W5 2TH.
Telephone: 01-567 4717 or 01-579 1871.

WMIIII
The general anaesthetic
with a range of particular
qualities and advantages
Halothane-'M&B'- a May & Baker
presentation of the inhalation
anaesthetic that can be depended
on for consistency and reliability
in a wide range of surgical
procedures. Halothane offers a
well-established catalogue of qualities
which provide advantages for
anaesthetist and patient alike.
•Suitable for most types of surgery
•Can be given with a high proportion of
oxygen, if required
LjOf particular value when cautery or
diathermy is used
QSuppresses salivary, bronchial and
gastric secretions
•Depth of anaesthesia easily controlled,
readily reversed
•Smooth and pleasant induction -
particularly for children
•Rapid and uneventful recovery.
'M&B' is a trade mark of May & Baker Ltd
Full information available on request to
May & Baker Ltd Dagenham Essex RM10 7XS
May&Bater
A werrtxi & me Rhfine-ftoulenc Gmto of Companes

QrCQll (naloxone)
the f irsfpure'
narcotic antagonist
The only narcotic antagonist with no agonist properties
No respiratory depression
No activity in the absence of strong analgesics
Antagonises pentazocine
Narcan is the first narcotic antagonist to
have no significant morphine-like (agonist)
activity. Potent and rapid-acting, Narcan
reverses respiratory depression and
unwanted sedation induced by strong
analgesics. But unlike other narcotic
antagonists, it does not itself produce
respiratory depression, analgesia, sedation
or miosis. It has no psychotomimetic
effects and does not cause tolerance or
dependence.
WIN
In anaesthesia to counteract respiratory depression when
strong analgesics are used to supplement anaesthetics.
Post-operatively to facilitate arousal for neurological
assessment.
In obstetrics to.counteract respiratory depression of strong
analgesics in labour, thus reducing risks of foetal hypoxia
and neonatal asphyxia.
In emergencies as an antidote to narcotic or pentazocine
overdosage and to aid diagnosis where opiates are the
suspected cause.
Narcan is unique among narcotic antagonists in reversing
the agonist effects of strong analgesics that
have partial antagonist activity, such as pentazocine
(Fortral).
Availability: Boxes cf 10 ampoules cf 1 ml each containing 0.4 mg naloxone.
'Narcan' and 'Fortral' are registered trade marks.
Fu'l 'n'cmafon ava !ab'c frcm ycur Ci 'ef Pharmacist or on request from:
Medical Information Department V.'int h rop LaboraUxies. Winthrop House.
Surbrton-upon-Thames. SURREY. KT6 4PH.

Just 4 bolts and a
compressed air line
that's all it takes to install
the KIFA H3 Table
• The most advanced operating table system available
• Reduces patient handling
• Provides unequalled x-ray facilities • Easily cleaned
-k Utterly reliable • Quick turn-round of patients
Table tops available for general, urological,
gynaecological, orthopaedic and micro-surgery.
Sierex will be pleased to supply details on request.
Sierex Limited
15 18 Capstone Street, London, W1P 8AE. 01 -580 2464
Branches in Aberdeen. Birmingham. Bristol. Bury St. Edmunds.
Dublin, Edinburgh. Glasgow, Leeds, Liverpool, Manchester and
Peadmg.
Acipnis m B" ' ••'• N-,-.castle and Newport.

Designed for a wide range of applications: cylinder
fitting, bed fitting, rail fitting and from wall pipelines.
Main features:
^ Back-pressure compensated flowmeter
calibrated 0 15 litres of oxygen per minute
* Sensitive needle valve control
* The regulator is fitted with a relief valve
and pressure gauge for indicating
cylinder contents
* A range of humidifiers and nebulisers of
various types can be used
A folder showing the range of components in the MIE
system is obtainable upon request
Medical & Industrial Equipment Ltd.
26 -40 Broadwick Street • London W1A 2AD Teh 01-734 3838
Cables• Narcosis. London W1 Telex:28455 Solariego Ldn.
Manchester Canada U.S.A.
061-224 1481 Niagara Falls Ontario Niagara Falls N.Y.

Engstrom Care System
ECS 2000
The Engstrom Care System 2000 integrates in a single unit, most functions necessary for intensive
care and anaesthesia during surgery. It consists of a number of modules which can be easily
combined by the user to achieve the desired function. The ECS 2000, which can be arranged for
wheeled stand, wall, or ceiling mounting, is electrically and pneumatically powered. The mains
supply is transformed to a 24-volt module supply. At present the
ECS 2000 comprises the following modules:
Mixer
The Mixer delivers the preset dosage of the
oxygen/air or oxygen/nitrous oxide mixture to
the anaesthesia circuit or to the Ventilator. Both
the dosage and the mixture ratio can be
independently adjusted.
Ventilator
The Engstrom Ventilator provides
volume controlled administration of the preset
minute volume. Operation is based on the
Engstrom principle and utilizes an increasing
force generator (primary system) and an
insufflation system (secondary system).
Ultrasonic Nebulizer
The Ultrasonic Nebulizer generates a fine water
aerosol in the breathing gases. All parts that
come in contact with the patient are
autoclavable.
Volume Display
The Volume Display simultaneously shows the
tidal and minute volumes in digital form. It also
provides continuous monitoring to ensure that
the preset minute volume and the expired
volume are in close agreement. Furthermore,
the Volume Display monitors the alarm signals
from all other modules.
Sales in the U.K.;
LKB MEDICAL LTD.
232 Addington Road, Selsdon,
SOUTH CROYDON, Surrey CR2 8YD
LKB MEDICAL
Division of
JUNGNER INSTRUMENT AB
Fack S-T712O SOLNA Stockholm. Sweden

THE NEW
FROM DOWNS
*l
off
T£S1 I
PICK" 1
PULSEI
GIVES DIRECT READING WITH AUDIBLE
AND VISUAL INDICATIONS
This improved unit will display a direct reading of the pulse rate. It also provides
a flashing red light and an adjustable pulsed tone, both of which are
synchronous with pulse beat.
Designed mainly for use in the operating theatre for constant monitoring of the
pulse rate by the anaesthetist during operative procedures and in the postoperative
recovery ward. It can also be used with advantage in any situation
where the pulse rate needs to be monitored.
Plus these further Advantages:
• Fully Automatic
• Stabilised Power Supply
• Variable Tone Level Control
• Photo Electric Pick-up
Fully Isolated Pick-up
Interference Rejection Circuits
Reliable Battery Condition
Indicator
DHSS Approval
Fully Illustrated brochure available on request
Downs Surgical Ltd
CHURCH PATH, MITCHAM, SURREY
CR4 3UE ENGLAND, Tel. 01-640 3422 .& 01-648 6291

"This excellent
induction
agent..*"*
". Methohexitone used as a single
induction agent in conventional doses
has demonstrated its safety by
causing no major physiological
changes that we could observe"*
This acceptability of methohexitone is based on
experience of millions of administrations over more
than ten years'worldwide use.
Induction is smooth, with minimal respiratory and blood
pressure changes. Recovery is predictably rapid and
uncomplicated with a marked absence of post-operative
complications.
Solutions are aqueous, easy to administer and relatively
stable.
A 70 mg induction dose from any of the multiple dosage
vials costs the hospital less than 5p.
* Robinson JSetal
Brit Med J, 1969,3:240 (Correspondence)
'Brietal Sodium'
methohexitone sodium
Further information is available on request.
Eli Lilly & Company Limited, Basingstoke, Hants.

Allen & Hanburys Ltd
Appointments:
Anaesthetist (Canada)
Faculty positions
Blease Medical Equipment Ltd
British Journal of Clinical Pharmacology
British Journal of Pharmacology
Canadian Anaesthetists' Society Journal
Der Anaesthesist
Downs Surgical Ltd
Editorial Board
Janssen Pharmaceutical Ltd
KabiVitrum Ltd
Lilly, Eli, & Co. Ltd
LKB Medical
331
INDEX TO ADVERTISERS
PAGE
xvii
XX
xviii
XV
XX
XX
xvi
xviii X
ii
xiii
iii
xi
viii-ix
PAGE
May & Baker iv
Medical & Industrial Equipment Ltd vii, xxi
Philips Medical Systems Ltd i
Port Arthur Clinic xx
Portex Ltd inside front cover
Sherwood Medical Industries xix
Sierex Ltd yi
Southern Illinois University School of Medicine xviii
Springer-Verlag xviii
Stephens, Andrew, (1947) Co. xvi
Subscription Order Form xii
Taylor Servomex Ltd xxii
Thomas, Charles C. xiv
Winthrop Laboratories inside back cover, v
British journal ol Anaesthesia
SUBSCRIPTION ORDER FORM
Subscription Department,
Macmilian Journals Ltd.,
Brunei Road,
Basingstoke,
Hampshire RG21 2XS
Please enter me for a year's subscription to the British Journal of Anaesthesia
starting with the issue dated
I enclose £10.50 (U.S.A. and Canada £12.50)
(Prices applicable only to orders started before the 31st December 1 975. Payment may be made in any currency at the current
exchange rate. Orders can only be serviced if accompanied by remittance Cheques should be made payable to Macmilian
Journals Ltd.)
Please note that all (ubscriptiont may take up to 4 weeks to process.
Name
Address . . .
.. Postal/Zip Code
Registered No: 785998 England Registered Office: 4 Little Essex St London WC2R 3LF

droperidol
sublimaze
fentanyl
a foundation
for total anaesthesia
The combination of dropendoi, a neuroleptic and
antiemetic, with fentanyl, a potent narcotic
analgesic, provides easy control, profound
analgesia, protection from operative stress and
allows rapid recovery postoperatively.
Full information is available from
Janssen Pharmaceutical Ltd,
Janssen House, Marlow, Bucks 3SL1ET.

CHARLES C THOMAS • PUBLISHER
PATHOLOGICAL PHYSIOLOGY FOR THE
ANESTHESIOLOGIST (2nd Ptg.) by Robert Hudson
Smith, Univ. of California, San Francisco. This
source of information on pathological physiology
has been designed for anesthesiologists by an
anesthesiologist. The material is divided into three
convenient sections dealing with coexistent pathology,
pathological states caused by anesthesia and
surgery, and the special problems posed by certain
pathological states for which surgery is being done.
This book will be of interest to the resident,
technician or specialist and the surgeon who has
the responsiblity for the care of the patient under
anesthesia while a technician administers the anesthetic.
'74, 600 pp., 4 il., 10 tables, $17.75, paper
PATHOLOGICAL AND PHARMACOLOGICAL
CONSIDERATIONS IN ANESTHESIOLOGY:
The Proceedings of the Twelfth Biennial Western
Conference on Anesthesiology. Edited by Verne L.
Brechner, Univ. of California, Los Angeles. (9
Contributors) This book contains introductory
material to tissue sensitivity and reactions of
organs to anesthetic agents. Anatomical considerations
important in the administration of anesthesia
involving pathology of heart disease, pain and pain
management, pulmonary physiology, the place of
new anesthetic agents in the practice of anesthesia
and factors affecting the anesthesiologist in his
environment are discussed. '73, 288 pp., 145 il., 1
table, $13.25
ENDOCRINES AND ENZYMES IN ANESTHES-
IOLOGY. Edited by Carter M. Ballinger, Univ. of
Utah Medical Center, Salt Lake City, and Verne L.
Brechner, Univ. of California, Los Angeles. (20
Contributors) Important subjects discussed in this
book include enzyme induction by barbiturates
and other drugs, genetic variability of enzymes,
hazards of steroid associated with anesthesia and
fluid and electrolyte changes in endocrine disease,
and their significance in anesthesia. Also considered
are surgery and anesthesia of the thyrotoxic
patient, insulinogenic reserve in unstable and
stable diabetics and normal subjects and exaggerated
hormonal responses to anesthesia. '73, 256
pp. (6 3/4 x 9 3/4), 72 il., 44 tables, $23.70
XIV
Orders with remittance sent, by air, postpaid
ADVANCES IN RESPIRATORY CARE AND
PHYSIOLOGY. Compiled and edited by Thomas B.
Caldwell, HI, and Frank Moya, both of the Univ. of
Miami, Miami, Florida. (24 Contributors) The contributors
of this book deal with the physiology of
respiration and its application in mechanical ventilation,
inhalation therapy and cardiopulmonary resuscitation.
Advances in lung lavage, liquid breathing
and extracorporeal oxygenation are included. The
five sections of the book cover respiratory physiology,
inhalation therapy, recent advances in managing
ventilatory failure, mechanical ventilation and
cardiopulmonary resuscitation. '73, 376pp., 61 il,
24 tables, $16.75
THE NEUROPHYSIOLOGICAL BACKGROUND
FOR ANESTHESIA by Mary A. B. Brazier, Univ.
of California, Los Angeles. The effects of anesthesia
on the nervous system are described. The five
main sections encompass the physiology of pain as
followed from the receptor through the spinal
cord to the brain, general and local anesthesia, the
innervation of muscle and its reaction to relaxants,
and the brain mechanisms involved in the memory
process as learned from pathology. A final section
covers the many electrical signs of anesthetic
agents the electroencephalogram and responses
evoked by sensory stimulation, recorded at the
scalp and in the ascending reticular system of the
brain stem and thalamus. '72, 144 pp., 44 il.,
$13.75
INTERNATIONAL SYMPOSIUM ON MALIG-
NANT HYPERTHERMIA. Edited by R. A. Gordon,
Beverley A. Britt and Werner Kalow, all of
the Univ. of Toronto, Toronto, Canada. (66
Contributors) This volume discusses the clinical
recognition and management of this highly fatal
disorder, recognizes hereditary and genetic basis of
the trait and reports basic investigations of the
mechanisms involved in this syndrome derived
from studies of human patients and strains of
swine which show a similar phenomenon. Elucidation
of these basic mechanisms is essential to the
recognition and treatment of this syndrome and,
hopefully, to the recognition of patients at risk.
'73, 512 pp., 131 il., 55 tables, $22.50
301-327 East Lawrence Avenue • Springfield • Illinois . 62717 . USA

the easy part of a difficult operation
i THE
BLEASE
' MAN1EY
VENTILATOR
BLEASE MEDICAL EQUIPMENT LIMITED
DEANSWAY
T«l«phoni: Cheshtm 4422
CHESHAM BUCKS
Telu 83119 Mxllcal Chnhim
XV

XVI
NEW ELECTRONIC
SPHYGMOMANOMETER
NO STETHOSCOPE REQUIRED
AUDIO—VISUAL
HEAVY DUTY MODEL FOR WARD,
THEATRE, DAY-LONG USE,
MASS SCREENING, ETC.
The supersensitive ceramic microphone in the cuff "hears" the korotkow sounds as the cuff is deflated,
relaying them to the amplifier circuitry, causing a red light to flash on the manometer dial simultaneously
with bleep sound. The first flash/bleep noted is "systolic"—continuing flashing/bleeping with pulse beat
—the last flash/bleep indicates "diastolic". A particularly high quality IC solid-state unit. Fast inflation
system to desired mm Hg. Aneroid dial 20-300 mm Hg. Bleep volume control or switch-off. Metal
cabinet construction with working type carrying case, for desk or wall mounting. Extra long tubes for
ease of use. Power: 4-1.5V long-life batteries. Battery charge indicator meter fitted. Dimensions: 120 x20
x110 mm. Weight: 1 kg. Price: £85.00 (U.K. + VAT).
ANDREW STEPHENS(1947)CO. 41/A Dickson Rd, Blackpool, U.K. Tel.23755
Overseas orders — please write for pro-forma invoice
CANADIAN ANAESTHETISTS' SOCIETY
JOURNAL
Editor
R. A. GORDON
Assistant Editor: GORDON WYANT
Editorial Board
MARCEL BOULANGER A. W. CONN RAYNALD DERY
KENNETH M. LEIGHTON BERNARD PAIEMENT
The Journal is issued bi-monthly for members of the Society and Subscribers. It
contains original articles and reviews on clinical and basic science subjects related
to Anaesthesia.
Annual Subscription $20.00 post paid (effective July 1, 197S)
The Secretary
Canadian Anaesthetists' Society
178 St. George Street, Toronto M5R 2M7, Ontario, Canada

When an
asthmatic patient
needs a
bronchodiiator
delivered by
intermittent
positive pressure
ventilation
VENTOLIN
Respirator Solution
provides maximum
bronchodilatation
with minimum
tachycardia
"If an ideal bronchodiiator drug is
one which produces maximum
bronchodilatation with minimum
tachycardia, a 0.5%salbutamol
aerosol ( Ventolin Respirator
Solution) administered by I. P. P. V.
is manifestly superior to a 0.5%
isoprenaline aerosol administered
in the same way. "
(Bill. med. J., 1970, 4. 465)
f With freedom from
adverse effects on myocardial
function or arterial
blood gases
B In a recent investigation of Ventolin
lm Respirator Solution (Scot. med. J.,
1974, 19, 191), given as a wet aerosol
for 3 minutes via a Bennett intermittent
positive pressure ventilator (about
lOmg of salbutamol BP), to 8 patients
in status asthmaticus a continuous
electrocardiogram was recorded and
m arterial blood samples for blood gas
IS analysis were obtained. The
S conclusions were as folio ws:
ft "It was concluded that in the dosage
Jp employed a salbutamol aerosol
g administered by I. P. P. V. produced no
g significant disturbance of myocardial
• function."
m "The mean admission Pa 02 was 58.6mm
^ Hg and stabilised at 61.4mm Hgjust
B before salbutamol administration. This
U was followed by a mean maximum
H increase of2.7mm Hg to 64.1mm Hg."
M "ThemeanPaCOifellfrom36.2mmHg
f to 33.9mm Hg 15 minutes after
M salbutamol administration, stabilising
g (34mmHg) at30minutes."
M "The mean pH rose from 7.39 in a
B stepwise manner after salbutamol
B administration to 7.42 30 minutes
• after." "-'
espirator Solution is an aqueous solution of
talbuttmol sulphate BP equivalent to a 0.5%
solution of salbutamol BP.
Full prescribing information is available on request
Ventolin is a trade mark of
ALLEN & HANBURYSLTD LONDON£2 SLA
'Ventolin sets a higher standard in Bronchodiiator Therapy
xvii

xviii
FACULTY POSITIONS
Available in new, rapidly-developing medical school located in
Springfield, Illinois, U.S.A.
Send curriculum vitae with inquiry to:
Robert B. Boettner, M.D.
Professor and Chairman
Department of Anesthesiology
Southern Illinois University School of Medicine
P.O. Box 3926
Springfield, Illinois, U.S.A. 62708
Anaesihesist
The organ of the
Austrian, German and Swiss Societies
of Anaesthesiology and Reanimation
Edited by: R. Frey, Milnx; F. Kem, St. Gallen; O. Mayrhofer, Wien
verging Editor: A. Doenlcko, MOocbeo. Chirurgucbo UnlveniUU-PoUkliailc Aniwtheilo. D-8000 MOnchen 2, Pcttenkofentr. 8m
Content* APRIL 1975
E. Frcyc High doses of fentanyl as the sole anaesthetic agent and naloxone
as its antagonist.
F. T. Schuh Clinical neurormiscular pharmacology of AH8165D, an azobisarylimidazo-pyridinium-compound.
W. Strey, G. Richter, S. Lange On the pressure-volume relation of the central and the peripheral
vascular bed of the low-pressure system.
L. Tonczar, E. Rochowanski, Blood gas changes during heart catheterizadon in children under
W. Pokorny, P. Probst basal sedation.
E. Voigt, W. WeitzsScker Gas exchange and pulmonary mechanics under anaesthesia and
artificial ventilation.
I. Frank, W. Noack, Light- and electron-microscopic investigations of pulmonary tissue
P. P. Lunkenheimer, et aL after high-frequency positive-pressure ventilation (HFPFVj.
L Monies-Chass, E. Wajsbort, Massive aspiration during surgery for a hydatid cyst of the lung.
F. R. Zveibil
H. Alter, S. Jeretin, W. PrHmnnn Study on the time requirements of nursing care in an intensive
care unit.
G. Seher, A. Janda Tension pneumothorax as a complication of anaesthesia: report
on three cases.
A. Alder, W. Gflntert "Narcose a distance" for pneumocncephalography using the X-ray
apparatus Neurocentrix.
U. Renkes-Hegend5rfer The usefulness of system analysis to reduce the anaesthetic risk.
Published by SPRINGER-VERLAG • Berlin • Heidelberg • New York

Take this tip to reduce
pain and infection.
The Aero-Flo Tip of the Sherwood Argyle
Suction Catheter does just that.
When suction is applied, the smoothlycontoured
lip creates a cushion of air
between the tracheal mucosa and the
vent eyes and open distal end of the
catheter.
The 'tissue grab' associated with con-
Sherwood
MEDICAL INDUSTRIES
ventional catheters is virtually eliminated.
So your patient is subjected to far less
discomfort, or risk of mucosal damage
and subsequent infection. And, as with
all Sherwood disposables, you also
avoid cross-infection problems.
Isn't it a tip worth taking?
The Argyle
Aero-Flo Tip
Suction Catheter
Further information on request from:
London Road, County Oak, Crawley, West Sussex RH10 2TL
Telephone: Crawley (0293) 34501.'
Telex: 87685. Telegrams: Shermed, Crawley.
xix

ANAESTHETIST REQUIRED
Canadian Clinic Group of forty physicians requires an
additional anaesthetist to add to its present staff of three
full-time anaesthetists.
Certificated or Eligible.
Apply: Chief of Anaesthesia,
The Port Arthur Clinic,
194 N. Court Street,
Thunder Bay, Ontario,
P7A 4V7
Dritbh Journal
of Pharmacology
British Journal of Pharmacology, the
monthly journal of the British Pharmacological
Society publishes original papers on all aspects of
drug action including chemotherapy,
pharmokinetics, psychopharmacology and
autopharmacology. It has an international
readership of biochemists, physiologists,
immunologists, molecular biologists and clinicians.
Recent Papers include:
The specificity of some agonitsts and
antagonists for nicotine-sensitive receptors
in ganglia, R.B. Barlow, Bowman, Frances,
R.R. Ison & D.S. McQueen. Hyperglycaemia
produced by the polyamines spermine and
spermidine, D.J. Anderson & G.G. Shaw.
Annual subscription £30.00 (£35.50 U.S.A.
and Canada).
Price* applicable only to orders tuned before the 31 tt
December. 1975. Payment may be made in any currency at
the current exchange rate Orders must be accompanied by
remittance. Cheques should be mide payable to:
Macmillan Journals Limited,
Subscription Department Brunei Road,
Basingstoke, Hampshire RG21 2XS. England.
Dritbh Journal of
Clinical Pharmacology
British Journal of Clinical Pharmacology,
published bi-monthly, provides a specialist
communication medium for information on a subject
recognised as having major importance in all
medical fields. The British Journal of Clinical
Pharmacology publishes papers from clinical
academic departments, from the pharmaceutical
industry and from research institutes in the U.K. and
overseas, thus encouraging the cross-fertilization of
ideas and avoiding the dangers of compartmentalization.
Recent papers have included :
Physiological response to propranolol and
diazepam in chronic anxiety, P. J. Tyrer &
M. H. Lacier. Bioavailability of commercial
tetracycline products, D. B. Barnett, R. N. Smith,
N. D. Greenwood & C. Hetherington. Interactions
with warfarin, A. Breckenridge.
Annual subscription £20.00 (£22.00 U.S.A.
and Canada).
Prices applicable only to orders started before the 31 st December.
1975. Payment may be made in any currency at the current exchange
ratt. Orders must be accompanied by remittance. Cheques should be
made payable to:
Macmillan Journals Limited,
Subscription Department, Brunei Road.
Baungstoke, Hampshire RG21 2XS England.

Particularly for surgical
procedures in the region
of the head and neck
The light weight Bain Circuit is
designed as a single limb: a
tube-within-a-tube which offers
simplicity and minimum bulk.
It does not cause facial distortion
or excessive drag on the
endotracheal tube.
A descriptive technical folder is
obtainable upon request.
fir
Breathing
Circuit
Medical & Industrial Equipment Ltd.
26 40 Broadwick Street • London W1A 2AD Tel. 01-734 3838
Cables^ Narcosis. London W1 Telex^ 28455 Solariego Ldn.
Manchester Canada U.S.A.
061224 1481 Niagara Falls Ontario Niagara Falls NY
XXI

Accuracy saves
livesXan you afford
to be without it?
Accurate analysis of the oxygen content of anaesthetic gases,
incubator supplies and patients' breathing can be a vital factor in
saving lives. The greater the accuracy, the more you can rely upon
the analysis.
The Taylor Servomex OA262 oxygen analyser, designed specially
for medical use has three switched ranges 100%, 25% and 10% F.S.D.
It is intrinsically safe (BASEEFA* >. The OA262 is portable and
robust (it even has Lloyds approval for shipboard use >, is not
affected by other gases and can easily be sterilised. Easy to
calibrate. Easy to use. Easy to read, and comes complete
with its own stand.
Powered from four small batteries. Works perfectly
k over a wide range of temperatures and positions, and is
, virtually unaffected by any other gases in the sample.
A simple hand aspirator pumps the sample into the
analyser, and the oxygen content is accurately
measured directly.
When accuracy matters, you cannot afford to be
without it.
So find out about the Taylor Servomex OA262 today.
AT/JYLOR SERUOMEX
\ ^ SYBRON CORPORATION
Taylor Servomex Limi i ••;!. Crowborough. Sus.sex.
i.'n,ri-.,,,i '!v.i..;-h.,-,.->8