Cannulation of the radial and dorsalis pedis arteries.

The complications inherent in cannulation of the radial (group I) and dorsalis pedis (group II) arteries were studied in 46 patients. All the local and systemic variables which might be considered to contribute to damage of the artery were studied, from which it appeared that only the duration of cannulation, prothrombin time and partial thromboplastin time were significant in determining post-cannulation blood flow. A 20-gauge Teflon cannula was used in all patients and velocity of flow measured with a Doppler velocimeter probe. A majority of arteries showed a reduction of flow velocity for 24-72 h after the removal of the cannula, with evidence of improvement at 120 h. In six arteries--three in each group--flow ceased altogether after 24-72 h. No disability of either hand or foot resulted.

The choice of anesthesia as a career by undergraduates in a Saudi university.

In order to find out the career preferences of Saudi medical undergraduates as they relate to anesthesiology, questionnaires were distributed and received from 40 pre-clinical students and 26 clinical students immediately after their two-week anesthesia posting. Almost half of the preclinical students made their final choice. None of the students in this group made anesthesiology a first choice, though about 67.5% had heard about anesthesia. Among the students in the clinical group, medicine, surgery and general practice were the most common choices. Only one indicated anesthesiology a first choice. Most of the clinical students indicated that their I.C.U. rotation was the most enjoyable part of their anesthesia posting. The student's suggestions for improvement in their posting included a longer period than the present 2 weeks and more opportunity to acquire the required clinical skills. The authors advise a positive drive to Saudi medical undergraduates to take up the specialty of anesthesiology as a career in order to correct the present shortage.

Pancuronium and histamine release.

Both d-tubocurarine and pancuronium release histamine in the skin: both have been shown to cause bronchospasm after intravenous injection. It is unlikely that skin testing with either drug will detect an individual susceptibility to bronchospasm, except as a non-specific test for atopy.

Arterial oxygen tensions during the induction of ether and air anaesthesia with spontaneous respiration.

Arterial oxygen tensions were measured during the induction of ether and air anaesthesia with the EMO Inhaler and spontaneous respiration. Severe degrees of anoxia were demonstrated; these were often associated with normal or above normal minute volumes. The danger of anoxia can be alleviated either by supplying oxygen or by the use of relaxants and positive pressure ventilation or both. A choice of priorities has often to be made by those in authority in developing countries where resources of material and manpower are limited and logistic support erratic. Every effort should be made to encourage a supply of oxygen in such circumstances. The training of anaesthetic staff is of paramount importance and it is a great pity that the equivocal attitude of the professions, both medical and nursing, in Britain towards the training of nurses and paramedical personnel in anaesthesia does little to encourage such training in developing countries.