Drowsiness after epidural opioids

B.L. SMITH thesia and sedation with Entonox. This proved effective and surgery was completed without further problems. Postoperatively, the parent gave a history of two months dysphagia and weight loss following the original hip procedure. Subsequently, using the same rhinoscope, under ketamine and local anaesthetic, the mucous cyst was incised and deroofed, and a clear glairy fluid was released. Three weeks later there was no sign of the cyst and the child was eating well and was uncomplaining. Accounts of crico-arytenoid arthritis in juvenile chronic arthritis are well d o c ~ m e n t e d , ~ . ~ but the formation of a laryngeal mucous cyst after intubation is not. It is reported since it is a potentially hazardous sequel of guided intubation with a fibre optic device with the inevitable minor trauma that accompanies this procedure. Wexham Park Hospital, Slough, Berkshire