Abstract
The U .S. system works smoothly and well. There is a delay of fifteen minutes or more between cases. The cough reflex usually returns during pharyngeal and tracheal toilet. Post-operatively the patients seem to do well. All cases, apart from the thoracic and E.N.T., are transferred to a postoperative ward next to the theatre where there is a specially trained staff. The anresthesiologist visits this ward from time to time during the day and is on close call at any time if required. Unconscious patients are nursed in the lateral or semi-prone position. My feeling is that the system is simple and safe, and the results good. Possibly the results are not quite so good as ours where we have doctors administering the anresthetics and are therefore allowed a wider and more appropriate range of agents. I do not like their extensive use of spinals.
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