Minerva

Anaesthetists and pregnant women have waited for more than a decade for randomised evidence on a suggested association between epidural analgesia in labour and back pain. The results are reassuringly negative (British Journal of Obstetrics and Gynaecology 2001;108:27-33). Against all the odds, researchers recruited 369 primigravid women who were happy for their pain relief to be decided by a computer acting at random. Those who were allocated an epidural had no more back pain in the year after delivery than controls who received intramuscular pethidine. The epidural group had more instrumental deliveries, however.

As rates of coronary angiography and revascularisation continue to climb steeply, Australian researchers ask: what is the “best” rate for Australians in the subacute phase after a heart attack? After a systematic review (Medical Journal of Australia 2001;174:130-6) they conclude that rates above 30% for coronary angiography, and 20% for revascularisation probably don't save any more lives or prevent any more heart attacks. To make sense of their review however, policymakers will need to update their data on the use of these procedures in Australia—the latest were obtained more than four years ago.

If you are running a link between a health facility in Britain and a corresponding service in the developing world, make sure your …