BMJ 1997; 314 doi: https://doi.org/10.1136/bmj.314.7075.238 (Published 18 January 1997) Cite this as: BMJ 1997;314:238

One of Minerva's anaesthetist colleagues observes that pethidine is still widely used in labour in the hope of relieving pain. Yet in a recent double blind trial at the Karolinska Hospital (British Journal of Obstetrics and Gynaecology 1996;103:968-72) neither pethidine nor morphine, titrated intravenously, produced even a brief reduction in pain scores. Sedation increased progressively with successive doses. Though women reported reduced anxiety with both drugs and even “exhilaration” with pethidine, three quarters requested epidural anaesthesia. The authors wrote that it seemed medically incorrect to meet the parturient's request for analgesia with heavy sedation. Unfortunately the NHS cannot provide epidural anaesthesia universally.

Growth hormone has been shown to be an effective treatment for heart failure in patients with idiopathic dilated cardiomyopathy. An editorial in Heart (1997;77:1-2) is cautious about the long term value of this treatment, but it concludes that the preliminary data are “impressive.”

It was the late great Lord Rosenheim who observed that the biggest advance that could be made in medicine was for full use to be made of existing knowledge. The Journal of Medical Screening (1996;3:169) has highlighted one example: diabetic retinopathy continues to be an important cause of blindness before the age of 64, yet half the patients registered as blind from this …

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