Front Matter (PDF) - BJA

-7
Volume 5O,No.2 February 1978

*Pre-operatively
In total intravenous
anaesthesia
*Post-operatively
the non-opiate
strong analgesic
Fortral (pentazocine)
is available as injections, capsules,
tablets and suppositories.
Fortral is a registered trade mark.
'fc Reports of clinical studies on the use of Fortral in these and many other aspects of anaesthesia, and full
prescribing information, available on request from Winthrop Laboratories, Surbiton-upon-Thames, Surrey.
WINTHROP

105
BRITISH JOURNAL OF ANAESTHESIA

105
British Journal
of
Anaesthesia
Editor of General Issues
A. A. SPENCE
M.D., F.F.A.R.CS.
Editor of Postgraduate Educational Issues
J. NORMAN
M.B., CH.B., PH.D., F.F.A.R.C.S.
VOLUME 50
1978
Published by
MACMILLAN JOURNALS LTD
4 Little Essex Street
LONDON WC2R 3LF

i Macmillan Journals Ltd, 1978
Printed in Great Britain by John Wright and Sons Ltd
The Stonebridge Press, Bath Road, Bristol BS4 5NU

JANUARY
EDITORIAL: Measurement in anaesthesia .. .. 1
C. M. Conway
SYMPOSIUM ON CLINICAL ASSESSMENT
Clinical assessment of respiratory function .. .. 3
J. R. A. Rigg and N. L. Jones
Preoperative assessment of patients with cardiac
disease .. .. .. .. .. 15
P. Foex
Preoperative assessment of the patient with liver
dysfunction .. .: 25
L. Strunin
Assessment of performance in studies of anaesthetic
agents 33
M. Herbert
Body temperature and anaesthesia 39
G. M. Hall
An assessment of acid-base balance .. .. 45
J. Norman
What is new in blood-gas analysis ? .. .. 51
J. P. Blackburn
The assessment of ventilator performance .. 63
L. Loh, M. K. Sykes and M. K. Chakrabarti
ABSTRACTS
Proceedings of the Anaesthetic Research Society,
London Meeting, October 22, 1977 .. .. 73
CORRESPONDENCE
Erythrocyte stability in ethanol-saline solutions .. 81
Antagonism of ketamine by physostigmine .. 81
Pentazocine and tremor following halothane anaesthesia
82
Tracheal cylindroma: anaesthetic management .. 82
Toxicity of local anaesthetics .. .. .. 82
A simple re-usable electrode system .. .. 84
Laparoscopy and suxamethonium muscle pain .. 84
Profound hypotension for middle ear surgery .. 84
An unusual cause of respiratory obstruction .. 85
Plasma cholinesterase and malignant hyperpyrexia 86
Structure of morphine and buprenorphine .. 86
Anti-pollution systems 87
Calculation of oxygen concentration in air .. .. 87
BOOK REVIEWS
Paediatric Anaesthesia .. .. .. .. 88
Principles of Resuscitation .. .. .. .. 88
Respiratory Therapy in Critical Care .. .. 88
FEBRUARY
EDITORIAL: Total intravenous anaesthesia
J. W. Dundee
EXPERIMENTAL
Detection and reversal of pulmonary absorption
collapse 91
J. P. Nunn, I. P. Williams, J. G. Jones, A. M.
Hewlett, G. H. Hulands and B. D. Minty
CONTENTS
89
An investigation of the centrally and peripherally
mediated cardiovascular effects of etomidate in
the rabbit 101
R. L. Hughes andj. E. MacKenzie
Some effects of the aminoglycoside antibiotic
amikacin on neuromuscular and autonomic transmission
109
Y. N. Singh, I. G. Marshall and A. L. Harvey
Effects of hypotension induced by halothane on the
cerebral circulation in baboons with experimental
renovascular hypertension .. .. .. 119
W. Fitch, J. V.Jones, D. I. Graham, E. T. Mac-
Kenzie and A. Murray Harper
The Bain system: gas flows in small subjects .. 127
D. J. Guiilt, V. A. Goat and P. Maynard
Effect of pentazocine on renal blood flow .. .. 133
H. Yamashiro
Analgesic effect of ethyl alcohol 139
M. F. M. James, A. M. Duthie, B. L. Duffy,
A. M. McKeag and C. P. Rice
A sensitive gas chromatograph assay for thiopentone
in plasma 143
M. J. Van Hamme and M. M. Ghoneim
A method of gas .chromatography using electroncapture
detection for the determination of blood
concentrations of halothane, chloroform and trichloroethylene
147
D. D. Davies
CLINICAL INVESTIGATION
Heat loss during anaesthesia 157
A. Holdcroft and G. M. Hall
Effects of a diazepam-fentanyl mixture on cerebral
blood flow and oxygen consumption in man .. 165
J. Vernhiet, A. M. Renou, J. M. Orgogozo, P.
Constant andj. M. Cailli
Effects of adrenaline and the concentration of
solution on extradural block with etidocaine .. 171
F. P. Buckley, D. G. Littlewood, B. G. Covino and
D. B. Scott
High spinal nerve block for large bowel anastomosis.
A retrospective study .. .. .. 177
A. R. Aitkenhead, H. Y. Wishart and D. A.
Peebles Brown
Hyperglycaemic effects of Hartmann's solution
during surgery in patients with maturity onset
diabetes 185
D. J. B. Thomas and K. G. M. M. Alberti
Magnitude, dose-requirement and mode of development
of tachyphylaxis to suxamethonium
in man .. .. .. .. . • • • 189
C. Lee, A. Barnes and R. L. Katz
Suxamethonium-induced muscle contracture following
traumatic denervation in man .. .. 195
A. Bar oka
CASE REPORT
Fracture of a float catheter. A case report ..
D. S. Parulkar, E. M. Grundy and E. J. Bennett
201

VI CONTENTS
CORRESPONDENCE
British standard for ventilators .. .. .. 205
Orphenadrine and postoperative pain .. .. 205
Interactions between morphine and doxapram .. 205
Anaesthesia with profound hypotension for middle
ear surgery .. .. 206
MARCH
EDITORIAL: Pollution and performance
G. Smith
207
EXPERIMENTAL
Effect of cyclopropane on pulmonary vascular resistance
and hypoxic pulmonary vasoconstriction
in the isolated perfused cat lung .. .. .. 209
A. R. Tait, M. K. Chakrabarti and M. K. Sykes
Cardiac performance during prolonged halothane
anaesthesia in the cat. Isolated heart muscle study 215
S 1 . Shimosato and I. Yasuda
Simultaneous trace analysis of nitrous oxide and
halothane in air .. .. .. .. 221
L. A. Salamonsen, W. J. Cole and R. F. Salamonsen
Failure to replicate negative effects of trace anaesthetics
on mental performance 229
J. L. Frankhuizen, C. A.J. Vlek, A. G. L. Burm
and V. Rejger
Plasma concentrations of pancuronium during predetermined
intensities of neuromuscular blockade 235
C. A. Shanks, A. A. Somogyi and E.J. Triggs
Porcine malignant hyperthermia. VI: The effects of
bilateral adrenalectomy and pretreatment with
bretylium on the he'.othane-induced response .. 241
J. N. Lucke, H. r ny, G. M. Hall, R. Lovell and
D. Lister ,
A low pass filtp a amplifier for measurement of
active and •• -re tensions of skeletal muscle in
vitro.. • 247
G. C.L>
Tobramj 7 iid neuromuscular transmission in the
rati' J phrenic nerve-diaphragm preparation 251
M. josayro and T. E. J. Healy
AL INVESTIGATION
.irment of oxygen transfer in the lung by inreasing
oxygen concentration during halothane
and trichloroethylene anaesthesia .. .. 255
G. B. Drummond, J.A.W. Wildsmith and A. H. B.
Masson
Pressure-volume relationships in the lung during
laparoscopy 261
. G. B. Drummond and L. V. H. Martin
A simple system for administering intermittent mandatory
ventilation (IMV) with the Oxford ventilator
271
D. A. Pybus andj. H. Kerr
Placental blood flow during Caesarean section under
lumbar extradural analgesia 275
R. Jouppila,P. Jouppila, J. KuikkaandA. Hollmen
Comparison of diazepam and flunitrazepam for
sedation during local anaesthesia for bronchoscopy
281
K. Korttila, L. Saarnivaara, J. Tarkkanen,J.-J.
Himberg and M. Hytonen
Fazadinium in anaesthesia 289
D. E. Rowlands and K. Fidler
The action of commonly used antiemetics on the
lower oesophageal sphincter 295
J. G. Brock-Utne, J. Rubin, S. Welman, G. E.
Dimopoulos, M. G. Moshal andj. W. Downing
CASE REPORT
Methaemoglobinaemia induced by mafenide acetate
in children. A report of two cases .. .. .. 299
M. Ohlgisser, M. Adler, D. Ben-Dov, U. Taitelman
H. J. Birkhan and S. Bursztein
CORRESPONDENCE
Topical lignocaine in poor-risk cases .. .. 303
Anaesthetic doses for extradural anaesthesia in
children 303
Test doses in extradural analgesia 304
Venturi ventilation for bronchography .. .. 304
Gas evacuation from paediatric anaesthetic systems 305
Hypersensitivity to atropine .. .. .. 305
A simple suction apparatus .. .. .. 306
World Congress of intensive care 306
Awareness during anaesthesia .. .. .. 307
Disposition of pethidine in childbirth .. .. 307
Apomorphine .. .. .. .. .. .. 308
A new arm position .. .. .. .. .. 308
BOOK REVIEWS
Progress in Surgery .. .. .. .. .. 309
Ion and Enzyme Electrodes in Biology and Medicine 309
Respiratory Failure 310
Dictionary of Medical Ethics. .. .. .. .. 310
Applied Cardiovascular Physiology .. .. 310
Persistent Pain. Modern Methods of Treatment .. 311
An Introduction to Neurosurgery .. .. ..311
Regional Differences in the Lung .. .. ..311
Lehrbuch der Anaesthesiologie, Reanimation und
Intensivtherapie .. .. .. .. .. 312
Tracheostomy and Artificial Ventilation in the Treatment
of Respiratory Failure .. .. ..312
APRIL
EDITORIAL: Continuing controversy about a
College of Anaesthetists 313
A. A. Spence and J. Norman
EXPERIMENTAL
Acid-base balance and neostigmine antagonism of
pancuronium neuromuscular blockade .. .. 317
R. D. Miller and L. L. Roderick
The uptake and elimination of chloroform in man 325
N. Poobalasingham andj. P. Payne
A comparison of the cardiorespiratory effects of
continuous positive airway pressure breathing
and continuous positive pressure ventilation in
dogs 331
A. Scott, A. E. G. Hill, M.K. Chakrabarti and
B. Carruthers
Pulmonary shunting and lung volumes during
hypotension induced with trimetaphan.. .. 339
D. S. Skene, S. F. Sullivan and R. W. Patterson

CLINICAL INVESTIGATION
A preliminary investigation of the renal and hepatic
excretion of gallamine triethiodide in man.. 345
5. Agoston, G. A. Vermeer, U. W. Kersten and
A.H.J. Scaf
Effects of tracheal intubation on intracranial pressure
following induction of anaesthesia with
thiopentone or Althesin in patients undergoing
neurosurgery 353
E. Moss, D. Powell, R. M. Gibson and £>. G.
McDoviall
Comparison of speed of onset of fazadinium, pancuronium3
tubocurarine and suxamethonium.. 361
C. L. Blackburn and M. Morgan
Effect of undemutrition on uptake and distribution
of i.v. anaesthetic agents. A study in mice .. 365
R. A. Saraiva, L. I. Naganuma and M. Sete
Intraocular pressure changes during halothane and
enflurane anaesthesia 371
J. C. Runciman, R. M. Bowen-Wright, N. H.
Welsh andj. W. Downing
Haemodynamic studies during induction of anaesthesia
for open-heart surgery using diazepam and
ketamine 375
A. P. F.Jackson, P.R.Dhadphale,M.L.Callaghan
and S. Alseri
Postoperative angalesia following brachial plexus
block 379
R. S. Neill
CASE REPORTS
Effects of 4-aminopyridine in Eaton Lambert
syndrome 383
5. Agoston, T. van Weerden, P. Westra and
A. Broekert
Hyperpyrexia of uncertain origin 387
J. F. Murray
Misplacement of nasogastric tubes and oesophageal
monitoring devices .. .. .. .. 389
A. J. Svieatman, P. A. Tomasello, M. G.
Loughhead, M. Orr and T. Datta
HISTORICAL
Dr Nooth and his apparatus. The role of carbon
dioxide in medicine in the late eighteenth century 393
D. Zuck
CORRESPONDENCE
Difficult laryngoscopy because of cervical bony
spicules 407
A new blade for endotracheal intubation .. .. 407
Electrical conductivity of flowmeter tubes .. 408
Factors influencing arterial oxygen tensions .. 409
Ayre's T-piece and pollution 409
Relative analgesia 410
BOOK REVIEWS
Life Support—The Essentials 412
Hypnosis in Practice 412
Abrege de Mid&cine d'Urgence et d'Anesthisie
Rianimation .. .. .. .. .. 412
CONTENTS vu
MAY
EDITORIAL: Ethical problems in clinical research
and intensive care
J. P. Payne
413
EXPERIMENTAL
Equations for vapour pressure versus temperature:
derivation and use of the Antoine equation on a
hand-held programmable calculator .. .. 415
R. C. Rodgers and G. E. Hill
A vaporizing system for programmed anaesthesia 425
R. F. Salamonsen
A method for comparing endotracheal cuffs. A controlled
study of tracheal trauma in dogs .. .. 435
J. Homi, W. Notcutt, J.J.Jones and R. B. Sparke
Bedside estimation of whole blood lactate .. .. 445
W. P. Soutter, F. Sharp and D. M. Clark
A study of the enhanced toxicity of doxapram in
rodents treated with narcotic analgesics .. 451
B. J. Pleuvry
Multipeaking of the compound electromyographic
response to single nerve stimulus: its occurrence
and prevention in an experimental model .. 459
C. Lee, A. J. C. de Silva and R. L. Katz
CLINICAL INVESTIGATION
Droperidol, fentanyl and morphine for i.v. surgical
premedication .. .. .. .. " .. 463
J. T. Conner, G. Herr, R. L. Katz, F. Dorey, R. R.
Pagano and D. Schehl
Lorazepam, hyoscine and atropine as i.v. surgical
premedicants 471
R. R. Pagano, J. T. Conner, J. W. Bellville, C. W.
Graham, D. Schehl and R. L. Katz
Resistance of Heidbrink-type expiratory valves .. 477
M. R. Nott andj. Norman
Preliminary investigation into a new method of
assessing the quality of anaesthesia: the cardiovascular
response to a measured noxious stimulus 481
T. M. Savege, M. Dubois, M. Frank andj. M. P.
Holly
Haemodynamic response to induced arterial hypotension
in children .. .. .. .. 489
M. R. Salem, T. Toyama, A. Y. Wong, H. K.Jacobs
and E. J. Bennett
Glucose tolerance during anaesthesia and surgery.
Comparison of general and extradural anaesthesia 495
A. Houghton, J. B. Hickey, S. A. Ross and J.
Dupre
Anaesthesia for laryngoscopy. A technique using
the Nuffield Anaesthetic Ventilator .. .. 501
D. A. Pybus, A. F. O'Connor andj. D. Henville
Acute epiglottitis in children. Review of 27 patients 505
H. Breivik and 0. Klaastad
CASE REPORT
The fibreoptic laryngoscope in the management of
cut throat injuries
J. R. Davies
511

Vlll CONTENTS
OPINION
A nurse's view of ethical problems in intensive care
and clinical research .. .. .. .. 515
V. A. Bishop
HISTORICAL
A history of nitrous oxide and oxygen anaesthesia.
IVC: Henry Hill Hickman in his time .. .. 519
W. D. A. Smith
Extended Guide to Contributors 531
JUNE
EDITORIAL: The preoperative assessment of
patients 539
J. Norman
EXPERIMENTAL
Diuretic-induced hypokalaemia, pancuronium
neuromuscular blockade and its antagonism by
neostigmine 541
R. D. Miller and L. L. Roderick
Quantitative analysis of the effects of volatile
anaesthetics on cortical electroencephalograph
activity 545
J. Jaramillo
A new mouthpiece for the Wright peak flow meter 551
J. A. Bushman, A. AH, I. R. Perry and G. M. E.
Williams
CLINICAL INVESTIGATION
Nitrous oxide and neutrophil chemotaxis in man 555
G. E. Hill, J. B. English, T. H. Stanley, R.
Kawamura, E. A. Loeser and H. R. Hill
Gastric emptying following hysterectomy with
extradural analgesia .. .. .. .. 559
W. S. Nimmo, D. G. Littlewood, D. B. Scott and
L. F. Prescott
Effect of segmental extradural analgesia on
placental blood flow during normal labour .. 563
R. Jouppila, P. Jouppila, A. Hollmin and J.
Kuikka
Effect of anaesthesia for delivery on the weight of
infants during the first 5 days of life .. .. 569
E. Abouleish, A. Van der Donck, H. Meeuwis and
F. Taylor
Combined i.v. bolus and infusion of pancuronium
bromide 575
A. A. Somogyi, C. A. Shanks and E. J. Triggs
Intermittent mandatory ventilation during anaesthesia
using the Manley Servovent ventilator .. 583
A. Perel, R. Katzenelson, F. Magora, S. Cotev
andj. T. Davidson
Intubation lesions of the larynx 587
V. Kambii and Z. Radiel
Comparative study of the effects of oral and i.m.
atropine and hyoscine in volunteers .. .. 591
R. K. Mirakhur
A comparison of buprenorphine and pethidine for
immediate postoperative pain relief by the i.v.
route 599
Af. M. Kamel and I. C. Geddes
A double-blind comparison of morphine and
buprenorphine in the prevention of pain after
operation .. .. .. .. .. 605
B.Kay
CASE REPORT
True anaphylaxis to suxamethonium chloride.
A case report .. .. .. .. .. 611
D. Royston and R. G. Wilkes
APPARATUS
A rapid-response u.v. halothane meter ..
Af. L. Tatnall, P. G. West and P. Morris
617
HISTORICAL
A history of nitrous oxide and oxygen anaesthesia.
IVD: Henry Hill Hickman in his time .. 623
W. D. A. Smith
ABSTRACTS
Proceedings of the Anaesthetic Research Society,
Belfast Meeting, March 18, 1978 .. .. 629P
CORRESPONDENCE
Automatic ventilation during bronchoscopy.. .. 635
Non-depolarizing relaxants and liver disease .. 635
Awareness during endotracheal intubation .. .. 636
Four experiences in intubation of one patient with
Still's Disease 636
Ventilator for intermittent mandatory ventilation 636
College of Anaesthetists .. .. .. .. 637
BOOK REVIEWS
Applied Respiratory Physiology .. .. .. 638
Introduction to Anaesthesia. The principles of safe
practice .. .. .. .. .. .. 638
Cardiac Arrhythmias: Self-assessment .. .. 638
Manual of Anesthesia .. .. .. .. 638
Medical gases: their properties and uses .. .. 638
JULY
EDITORIAL: Hazards of anaesthesia
C.J. Hull andj. Norman
.. 639
SYMPOSIUM ON THE HAZARDS OF
ANAESTHESIA
Hazards in anaesthetic equipment .. .. .. 641
P. W. Spurring and B. K. Shenolikar
Electrocution hazards in the operating theatre .. 647
C. J. Hull
Fire and explosion hazards in operating theatres .. 659
Af. D. Vickers
Toxicity of inhalation anaesthetic agents .. .. 665
E. N. Cohen
Adverse reactions to i.v. induction agents .. .. 677
J. G. Whitwam
Drug interactions and anaesthesia .. .. .. 689
M. D. Rawlins
Postoperative respiratory failure: an anaesthetic
hazard ? 695
J. C. Stoddart

A review of the effects of trace concentrations of
anaesthetics on performance .. .. .. 701
G. Smith andA.W. Shirley
Is there a health hazard in anaesthetic practice ? .. 713
A. A. Spence and R. P. Knill-Jones
A medico-legal view 721
T. C. Gray and F. C. Shelley
CORRESPONDENCE
Modification of the Heidbrink expiratory valve .. 729
Serum concentrations of lorazepam .. .. 730
Anaesthetists' Joint Working Party on Hospital
Building Programme 730
Circulation-time models of the uptake of inhaled
anaesthetics .. .. .. .. .. 731
BOOK REVIEWS
Metabolism of Volatile Anaesthetics: Implications
for Toxicity 732
Medicine for Anaesthetists .. .. .. .. 732
AUGUST
5TH EUROPEAN CONGRESS OF ANAESTHESIOLOGY . . 733
EDITORIAL: Closed-circuit anaesthesia .. . . 7 3 3
J. F. Nunn
EXPERIMENTAL
The influence of bronchial smooth muscle tone on
critical narrowing of dependent airways .. 735
J. G. Jones, P. D. Graf and R. Lemen
Changes in airway calibre following pulmonary
venous congestion 743
J. G. Jones, R. Lemen and P. D. Graf
Control of intermittent positive pressure breathing
(IPPB) by extracorporeal removal of carbon
dioxide 753
L. Gattinoni, T. Kolobow, T. Tomlinson, D.
White andj. Pierce
Ventilatory effects and plasma concentration of
morphine in man .. .. .. .. .. 759
J.R.A. Rigg
Low ventilatory response to carbon dioxide not
associated with increased depression by morphine 767
J. R. A. Rigg
CLINICAL INVESTIGATION
The pharmacokinetics of fazadinium in man .. 773
P. Duvaldestin, D. Henzel, M. Demetriou and
J. M. Desmonts
Effects of fentanyl on intracranial pressure and
cerebral perfusion pressure during hypocapnia 779
E. Moss, D. Powell, R. M. Gibson and D. G.
McDowall
Biodegradation of halothane, enflurane and methoxyflurane
.. .. .. .. .. 785
T. Sakai and M. Takaori
Frequency of atopy and allergy in an anaesthetic
patient population 793
J. W. Dundee, J. P. H. Fee.J. R. McDonald and
R. S.J.Clarke
CONTENTS IX
Effect of halothane on the rate of acid production,
lactate production and pyruvate dehydrogenase
activity of malignant hyperpyrexia human muscle 799
D. Bennett, P. Cain, F. R. Ellis, J. Halsall and
C. F. Louis
Extradural analgesia revisited. A statistical study.. 805
E. M. Grundy, S. Ramamurthy, K. P. Patel, M.
Mani and A. P. Winnie
Bacterial contamination of anaesthetic gases .. 811
H. Nielsen, M. Vasegaard and D. B. Stokke
Effect of heating on the osmotic fragility of stored
blood 815
J. H. Van der Walt and W. J. Russell
The use of chlorazepate for premedication on the
night before surgery 821
A. R. Cohen, A. Levin, P. J. C. Houlton and A.
Wolhuter
Assessment of recovery from short anaesthesia
using the cerebral function monitor .. .. 825
M. Dubois, D. F. Scott and T. M. Savege
Cardiac arrhythmia induced by pneumoencephalography
833
G. Vourc'h and M. L. Tannieres
Use of propanidid and lignocaine to modify the
increase in serum potassium concentration
following injection of suxamethonium .. .. 841
E. N. S. Fry
CASE REPORTS
Unusual response to extradural analgesia in the
presence of an intradural spinal tumour .. 845
H. Renck and T. Torbergsen
Sodium nitroprusside for aneurysm surgery in
pregnancy. Report of a case .. .. .. 849
Y. Donchin, B. Amirav, A. Sahar and S. Yarkoni
HISTORICAL
A history of nitrous oxide and oxygen anaesthesia
IVE: Henry Hill Hickman in his time
W. D. A. Smith
853
CORRESPONDENCE
Dental anaesthesia .. .. .. .. .. 863
Better communication .. .. .. .. 863
Carotid artery palpation and distortion of QRS
complex during general anaesthesia .. .. 864
Decrease in intraocular pressure produced by i.v.
or conjunctival diazepam .. .. .. 865
Diazepam and intraocular pressure .. .. 866
Hypersensitivity to atropine 866
Neuromuscular blockade by neostigmine .. 866
Pentobarbitone distribution and enzyme induction 867
Meptazinol after open-heart surgery .. .. 867
Liver function after repeated halothane and
enflurane anaesthesia 868
BOOK REVIEWS
Anesthesia and Respiratory Function. International
Anesthesiology Clinics 869
Clinical Physiology of the Lung 869
Nutritional Aspects of Care in the Critically III .. 870
Immediate Care 870

SEPTEMBER
EDITORIAL: Animal experimentation .. .. 871
J. P. Payne
EXPERIMENTAL
Comparison of active and passive manoeuvres on the
pattern of airway closure in man .. .. 873
J. G. Jones and B. D. Minty
Effect of thiamylal on the sensitivity of glycerinated
cardiac fibres to calcium .. .. .. 881
N. Iwatsuki, I. Yasuda and K. Iwatsuki
Effects of age and sex on ketamine anaesthesia in the
rat 885
A. E. Waterman and A. Livingston
Effects of Althesin and ketamine on resting and
stress-stimulated adrenocortical activity in rats.. 891
G. Nisticd, N. Pisanti, D. Rotiroti, P. Preziosi,
R. Cuocolo, G. de Martino and G. M. Nisticd
Effects of halothane on glucose metabolism after
injury in the rat 899
D. F. Heath, K. N. Frayn andj. G. Rose
A study of naloxone and doxapram as agents for
the reversal of neuroleptanalgesic respiratory
depression in the conscious rabbit .. .. 905
V. K. Khanna and B. J. Pleuvry
Arterial dominance in the hand 913
B. Husum and T. Palm
CLINICAL INVESTIGATION
Frequency of previous anaesthesia in an anaesthetic
patient population 917
J. P. H. Fee,J. R. McDonald, J. W. Dundee and
R. S. J. Clarke
Use of

Death attributable to anaesthesia. A 10-year
survey {1967-1976) 1041
G. G. Harrison
Cerebral blood flow and metabolism during
etomidate anaesthesia in man 1047
A. M. Renou, J. Vernhiet, P. Macrez, P.
Constant, J. Billerey, M. Y. Khadaroo and
J. M. Caille
Serum thyroid hormone changes in patients undergoing
Caesarean section under general or
regional anaesthesia 1053
5. Halevy, M. Liu-Barnett, P. L. Ross and
M. S. Roginsky
Comparative study of two long-acting tranquillizers
for oral premedication .. .. .. .. 1059
M. E. Dodson and R. J. Eastley
Clearance of neostigmine from the circulation
during the antagonism of neuromuscular block 1065
N. E. Williams, T. N. Calvey and K. Chan
Neuromuscular refractoriness during blockage of
transmission. A quantitative study .. .. 1069
C. Lee, A. J. C. de Silva and R. L. Katz
Antagonism of neuromuscular block by physostigmine
in man .. .. .. .. .. 1075
A. Baraka
ABSTRACTS
Proceedings of the Anaesthetic Research Society,
Newcastle-upon-Tyne Meeting, July 8, 1978.. 1079P
NOVEMBER
EDITORIAL: Nitrous oxide and vitamin B12
J. Nunn and I. Chanarin
CONTENTS
1089
EXPERIMENTAL
Pressure reversal of general anaesthesia—a multisite
expansion hypothesis .. .. .. 1091
M. J. Halsey, B. Wardley-Smith and C. J. Green
Effect of certain anaesthetic agents on the activity
of rat hepatic 8-aminolaevulinate synthase .. 1099
R. K. Parikh and M. R. Moore
Muscle blood flow and rate of recovery from pancuronium
neuromuscular blockade in dogs .. 1105
C. P. H. Heneghan, I. L. Findley, C. E. Gillbe and
S. A. Feldman
Comparison of sampling techniques for studies of
nitrous oxide pollution .. .. .. ..1109
J. C. Austin, R. Shaw, R. Crichton, P. E. Cleaton-
Jones and D. Moyes
CLINICAL INVESTIGATION
A pharmacodynamic model for pancuronium .. 1113
C.J. Hull, H. B. H. Van Beem, K. McLeod, A.
Sibbald and M. J. Watson
Variation in the dispostion of morphine after i.m.
administration in surgical patients .. .. 1125
J. R. A. Rigg, R. A. Browne, C. Davis, J. K.
Khandelwal and C. H. Goldsmith
Pancuronium pharmacokinetics in patients with
liver cirrhosis .. .. .. .. .. 1131
P. Duvaldestin, S. Agoston, D. Henzel, U. W.
Kersten andj. M. Desmonts
Gastro-oesophageal pressure gradient changes
produced by induction of anaesthesia and suxamethonium
1137
G. Smith, R. Dalling and T. I. R. Williams
Relationship between stomach contents and analgesia
in labour 1145
J. D. Holdswonh
Premedication with lorazepam for bronchoscopy
under general anaesthesia .. .. .. 1149
J. M. Hewitt and A. Marshall Barr
APPARATUS
An automatic interference refractometer ..
K. V. Diprose and L. R. Redman
1155
SYMPOSIUM
Report of a symposium: adverse responses to
intravenous agents .. .. .. ..1159
J. Watkins and R. S. J. Clarke
MEDICAL STAFFING
Staffing in anaesthesia in Australia
A. B. Baker
1165
CORRESPONDENCE
Anaesthetists' Joint Working Party on Hospital
Building 1169
Sodium nitroprusside and liberation of cyanide .. 1169
Reaction to Althesin 1169
Ayre's T-piece and pollution .. .. .. 1169
Antoine equation coefficients for inhalation anaesthetic
agents 1170
Pentobarbitone distribution and enzyme induction 1170
DECEMBER •
EDITORIAL: The European Academy of Anaesthesiology
A. A. Spence
ACKNOWLEDGEMENT ..
1171
1172
EXPERIMENTAL
Decision-making behaviour during inhalation of
subanaesthetic concentrations of enflurane .. 1173
5. Bentin, G. I. Collins and N. Adam
Effects of small concentrations of enflurane on
probability learning 1179
5. Bentin, G. I. Collins and N. Adam
Preservation of the pulmonary vasoconstrictor response
to alveolar hypoxia during administration
of halothane to dogs 1185
M. K. Sykes,J. M. Gibbs, L. Loh,J. B.L. Marin,
J. Obdrzalek and R. N. Arnot
Lack of effect of morphine and buprenorphine on
hypoxic pulmonary vasoconstriction in the isolated
perfused cat lung and the perfused lobe of
the dog lung H97
J. M. Gibbs and H. Johnson

CLINICAL INVESTIGATION
Cardiorespiratory effects of increased airway pressure
during controlled and spontaneous breathing
after cardiac surgery .. .. .. 1203
H. Askitopoulou, M. K. Sykes and C. Young
Effect of age on amnesia and sedation induced by
flunitrazepam during local anaesthesia for bronchoscopy
1211
K. Korttila, L. Saarnivaara, J. Tarkkanen, J.-J.
Himberg and M. Hytonen
Althesin infusion and regional blockade anaesthesia
for major gynaecological surgery .. .. 1219
G. R. Park andj. Wilson
Extradural analgesia—the preferred method of
analgesia for vaginal breech delivery .. .. 1227
A. J. Breeson, G. T. Kovacs, B. G. Pickles and
J. G. Hill
Pharmacokinetics of Althesin—comparison with
lignocaine 1231
M. E. Simpson
Pharmacokinetics of thiopentone: effects of enflurane
and nitrous oxide anaesthesia and surgery 1237
M. M. Ghoneim and M, J. Van Hamme
Cardiac arrhythmia during outpatient dental
anaesthesia: a comparison of controlled ventilation
with and without halothane .. .. 1243
V. J. E. Thomas, K. P. Kyriakou and A. C.
Thurlom
Effects of glycopyrrolate and cimetidine on gastric
volume and acidity in patients awaiting surgery 1247
P. J. Keating, J. F. Black and D. W. Watson
Accuracy of gas flowmeters determined by the
bubble meter method 1251
J. Waaben, D. B. Stokke and M. M. Brinklov
CONTENTS
Theatre ventilation. A comparison of design and
observed values .. .. .. .. .. 1257
C. G. Male
CORRESPONDENCE
Ethical problems in intensive care .. .. 1265
Awareness during anaesthesia 1266
Difficulty in intubation 1266
Test-doses in extradural analgesia 1267
Inadvertent administration of 100% oxygen during
anaesthesia 1268
Hypotension following metoclopramide administration
during hypertensive anaesthesia for
intracranial aneurysm .. .. .. .. 1268
Mixing local anaesthetics .. .. .. .. 1269
Curare and ventilation .. .. .. .. 1269
Foreign body from double swivel connector in the
bronchial tree 1270
Committee on Safety of Medicines .. .. 1270
Electrical conductivity of flowmeter tubes .. 1270
Foetus or fetus ? 1270
BOOK REVIEWS
Recent Advances in Intensive Therapy .. .. 1271
Manual of Surgical Intensive Care .. .. 1271
Non-Respiratory Functions of the Lung and Anesthesia.
International Anesthesiology Clinics .. 1271
Local Anesthetics 1272
Second International Symposium on Malignant
Hyperthermia 1272
A Manual of Thoracic Surgery .. .. .. 1272
Index to Volume 50 1273