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SUMMARY A case is described of massive aspiration of liquid gastric contents into the lungs of an obstetric patient undergoing general anaesthesia. Pre-operative treatment with oral alkali to neutralize gastric acid did not prevent a severe reaction in the lungs. Treatment was by general supportive measures and long-term intermittent positive pressure ventilation via a tracheostomy. Great difficulty was experienced in ventilating the lungs because of their low compliance and the large physiological deadspace. Recovery was complicated by a severe reduction in pulmonary diffusing capacity and by the development of tracheal stenosis. The factors influencing the treatment and complications are discussed.

(1968). Cumberland and Westmorland Record Offices. Northern History: Vol. 3, No. 1, pp. 162-171.

An investigation, in volunteers, into the sensory effects of nitrous oxide and methoxyflurane showed that the subjective changes of reduction in visual awareness and heightened auditory awareness were not supported by objective measurement. Vision remained normal until the subjects became unresponsive, whilst hearing was in fact diminished. The analgesia produced by nitrous oxide was late in appearance relative to the other sensory changes and it disappeared very rapidly upon recovery. In contrast, analgesia appeared early with methoxyflurane and persisted well into the recovery period. The principal changes found were alterations in orientation in space, of intellectual attitudes, of mood and of emotional attitudes. The emotional attitudes were easily disturbed by extraneous noise or conversation and the need for a quiet approach not only to the induction of anaesthesia but also to the recovery from anaesthesia is stressed.