We report the occurrence of oesophageal perforation and dilatation during percutaneous tracheostomy. The Combitube was used for airway maintenance during this procedure. This case highlights the limitations of the Combitube when used in this situation.

Two patients presented with very different signs of central anticholinergic syndrome following general anaesthesia for which they had received premedication with hyoscine. Both responded dramatically to 1 mg of intravenous (i.v.) physostigmine, which produced a rapid return to a normal level of consciousness. The aetiology of central anticholinergic syndrome is multi-factorial, but the diagnosis should be considered in all patients who demonstrate abnormal post-anaesthetic awakening. It is recommended that 1 mg of intravenous physostigmine is a safe and effective treatment for central anticholinergic syndrome, and that a supply of this important drug must be kept readily available in the recovery area of the operating theatre department.

Two cases of atypical transurethral resection (TUR) syndrome occurring during the post-operative course are reported. Atypical clinical events such as confusion, drowsiness and sudden hypotension could not be explained by the amount of glycine fluid absorption, because in both cases this was less than 1000 mL. However, high serum concentrations of glycine were noted without marked hyponatraemia and with normal measured osmolalities. We suggest that the absorption of glycine is related to its high lipid solubility rather than to its direct passage through an evident prostatic effraction or periprostatic extravasation.