ALTHESIN INFUSION AND REGIONAL BLOCKADE ANAESTHESIA FOR MAJOR GYNAECOLOGICAL SURGERY

The effects of an infusion of a 10 % Althesin solution to induce sleep in patients undergoing major gynaecological surgery performed under extradural analgesia are presented. There was no significant depressant effect on the cardiovascular system, but a predictable and preventable depression of respiratory function. Liver function tests were unaffected by the infusion. Operating conditions were satisfactory in all patients and postoperative recovery was smooth and uncomplicated. The problem of operating theatre pollution by anaesthetic gases can be avoided only by total abstinence from the use of gaseous or volatile anaes-thetic agents (Dundee, 1978). This concept can be ful-filled by the use of regional blockade or by total i.v. anaesthesia and analgesia, according to the circum-stances (Savege et al., 1975; Mocavero, Gregorretti and Bosatra, 1976). A combination of these meets the needs of the patient who desires to be asleep during surgery but in whom regional techniques may provide the required analgesia and muscle relaxation for operation (Wilson, 1970; Dunhill, 1975). Certain i.v. agents have already been investigated in this context—chlormethiazole (Wilson, 1970), metho-hexitone (Kauste, 1976), propanidid (Downing