Cataract extraction under general anaesthesia.

IT seemed worthwhile confirming the work of Cridland (1955) who recorded a series of cataract extractions under general anaesthesia at a time when this method was used only by a minority. General anaesthesia for all ophthalmic surgery has come to stay. It would not be right to be dogmatic as more work needs to be done but, provided the patient is in satisfactory health, it merits serious consideration for all major intra-ocular operations. There is little need to reiterate the advantages, but the most important one is that the average surgeon will be a better performer and obtain better and more uniform results if he has no longer to contend with the reactions of the patient during operation. Skilled anaesthesia is, of course, essential, and we are fortunate that this is readily available in Great Britain. The majority of the cases in this series were handled by anaesthetists of registrar status using standard technique. It will be noted that an endotracheal tube was passed in all cases, and this is in agreement with the opinion of Sandiford (1955, 1957) as it gives the anaesthetist a much higher degree of control than the pharyngeal tube used by Harper (1956). Neither ether nor chloroform was used in any concentration, but at one hospital fluothane was used in a few cases with satisfactory results. There were, of course, small differences of procedure between the anaesthetists who gave their advice so freely, but an average routine is given in detail.