1233

CORRESPONDENCE

immediate moderate: (A-C)x = 4, 5 or 6 immediate severe: (A-C)j less than 4 prolonged moderate: (A-C)5 = 7 prolonged severe: (A-C)5 less than 7

SELWYN CRAWFORD

Birmingham REFERENCES

Crawford, J. S., Burton, M., and Davies, P. (1973). Anaesthesia for section: further refinements of a technique. Br. J. Anaesth., 45, 726. Davies, P. (1975). A return to trichloroethylene for obstetric anaesthesia. Br. J. Anaesth., 47,482. ANAPHYLAXIS TO SUXAMETHONIUM

Sir,—I read with interest the case reports of Dr Mandappa and his colleagues (1975). I feel strongly that they were not justified in administering suxamethonium to a patient who was already known to be sensitive to the drug. It is not surprising that the patient refused surgery after the second postponement of the operation. The Medic Alert Foundation issues to such patients identification emblems in the form of a bracelet or neck chain so that a drug which is known to cause an allergy will not be administered. Medic Alert Foundation Kuala Lumpur West Malaysia

TABLE I. Number of infants expressed as percentages with high and low Apgar-minus-colour scores at 1 min (A —C) x and 5 min (A —C)6 following Caesarean section with varying incision-delivery (I —D) intervals Percentages (A-

J.

ANTONY S. MAN AVAL AN

Based on these definitions, our rather small series of Group A elective sections yielded the following results (table I):

I-D

the incidence of depression is considerably less than that quoted by Dr Palahniuk, who refers to total Apgar scores and whose I-D intervals were considerably shorter (21% of our entire series had an (A — C \ score of 6 or less). As we are just completing a comparative study of general anaesthesia with lumbar extradural analgesia for elective Caesarean section, I would prefer to reserve comment upon the final observation made by Dr Palahniuk.

(A-C),

(min)

infants

4,5,6