ANESTHESIA IN NORTHERN IRAQ - AN AUDIT FROM A FIELD HOSPITAL

A Royal Naval field surgical team deployed to Iraq for 6 weeks. Sevent y-one anesthetics were administered to 52 patients. The Triservice ane sthetic apparatus (TSA) was used with controlled ventilation and eithe r halothane plus trichloroethylene or isoflurane. Other techniques inc luded spontaneous ventilation via the TSA, ketamine and midazolam, eit her with or without controlled ventilation, or local anesthesia. A sim ple modification allowed preoxygenation with 100% oxygen. Controlled v entilation with air alone was usually associated with satisfactory pul se oximetry and oxygen economy. Isoflurane was not significantly hypot ensive and recovery was more rapid than with halothane/trichloroethyle ne. Drawover techniques with controlled ventilation were satisfactory for children as small as 6.5 kg. Overnight ventilation was instituted on three occasions, and it was found that a simple positive end expira tory pressure system could be applied to the Laerdal valve. Pulse oxim etry, ECG, and automatic arterial pressure monitoring facilities were used. The total drug expenditure for all 71 anesthetics was only $178.