THE anaesthesia employed for hare-lip and cleft palate operations at the Babies' Hospital, Newcastle upon Tyne, may be divided into two phases-the nitrousoxide-oxygen phase and the oxygen-ether phase. In all cases the babies were intubated by the endotracheal technique of Dr. Magill, wide-bore rubber catheters being inserted through the mouth into the trachea just beyond the laryngeal opening. No especial difficulty was experienced in carrying out this procedure, except that on a few occasions the catheter entered a bronchus ; this was manifested clinically by laboured respiration and jerky movements of the diaphragm. On slightly withdrawing the catheter, the breathing became normal.
After prolonged trial, we found that, while nitrous-oxide-oxygen anasthesia afforded excellent results in adult patients, certain grave disadvantages presented themselves when the same anasthetic was administered to infants. In the first place, the anoxaemia caused by nitrous oxide-and any proportion of oxygen below 20 per cent represents some degree of sub-oxygenation-appeared to be much more deleterious to babies than to adult patients. In the second place, it was extremely difficult to adjust the amount of re-breathing to the small proportions suitable for a baby. No matter how small the re-breathing bag, there was always too much ~ ~~~ ~ * Messrs. A.