Feasibility of 'day case' laparoscopic cholecystectomy.

Laparoscopic cholecystectomy was offered as a day case to 15 patients (mean age 42; range 33-72 years). Three patients required overnight admission for non-operative reasons. The mean in-hospital stay for those patients successfully treated as day cases was 8.

Spondyloepiphyseal dysplasia congenita. Caesarean section under epidural anaesthesia.

Spondyloepiphyseal dysplasia congenita is a rare condition with several features of concern to the anaesthetist. The patients are of extremely short stature and the presence of kyphoscoliosis may lead to significant respiratory impairment. Cervical vertebral body changes can result in spinal cord compression and laryngotracheal stenosis may be present.

Coagulation screening before epidural analgesia in pre-eclampsia.

A questionnaire survey of current practice at a small cross-section of obstetric units, covering 22% of all United Kingdom deliveries, revealed a marked lack of standard practice regarding requests for coagulation screens on pre-eclamptic patients who require epidural procedures. A retrospective audit was therefore carried out on 434 coagulation screens requested for pre-eclamptic patients in whom epidural analgesia might have been considered. Borderline abnormalities of coagulation were found in only 10 patients (2%).

Smoking habits and attitudes of Durban metropolitan anaesthetists.

A modified World Health Organization questionnaire about the smoking habits and attitudes of health professionals was sent to all practising anaesthetists in the Durban metropolitan area. The most striking feature of the 102 replies (response rate 78%) was the trend away from smoking, 58% of respondents having smoked at some stage and only 19% currently smoking daily. The marked consensus on the steps which should be taken to curb public smoking correlated with the views of both the Medical Association of South Africa and the South African Medical Research Council.

The anaesthetist and the obstetric flying squad. Could complacency creep in?

The demands made upon the Bristol obstetric flying squad over the past 14 years have been analysed. During this period, the number of calls received per year has decreased dramatically. The reasons for this are discussed in the context of current obstetric practice.