Convulsions following surgery.

Sir,—May I offer some comments on the article by Drury and Gilbertson? (Brir. J. Anaesth. (1970), 42, 1021). (1) A likely cause of the hyperpyrexia is the combination of pediidine and atropine in conjunction with anaesthesia. Pediidine potentiates atropine and probably atropine potentiates pethidine. Pethidine is not needed for premedication, and probably can be dispensed with safely. (2) It is difficult to see why a patient's temperature should be allowed to reach 109*F before someone in the operating room notices that something is wrong. Temperature measurement is one of the simplest techniques in medicine. One can use an ordinary thermometer, or a thermistor. If the anaesthetist were to measure axillary temperatures every 5 or 10 minutes, many more cases of hyperthermia would be recognized in time to save the patient's life. Malignant hyperthermia is probably more frequent than the reports suggest, and routine temperature monitoring in surgery ought to be considered.