UK legislation requiring pre-slaughter stunning has certain exemptions for religious slaughter. Supporters of both Muslim (Halal) and Jewish (Shechita) slaughter methods claim that the efficiency of the bleed out is adversely affected by stunning. In this study, electrical stunning followed by neck cutting, and captive bolt stunning followed by neck cutting, were compared with the Muslim slaughter method (neck cutting without stunning) in sheep. Total blood loss and percentage blood loss, expressed as a percentage of live weight, were calculated and compared between groups. In addition, the time taken to reach 25%, 50%, 75% and 90% of total blood loss was calculated and compared. There was no apparent difference in the packed cell volume levels between groups. Slaughter method did, however, affect meat pH and colour. The results show that the bleed out after neck cutting is not adversely affected by electrical or captive bolt stunning; nor is an improved bleed out achieved by neck cutting without stunning.

Some supporters of religious slaughter methods claim that efficiency of bleed-out is adversely affected by stunning. Our previous study carried out in sheep at an abattoir comparing the Muslim method of slaughter without stunning with pre-slaughter stunning using a captive bolt or by electrical methods concluded that bleed-out is not adversely affected by stunning, nor improved by a neck cut without stunning. In this paper, a similar study carried out in cattle is reported. In this study, captive bolt stunning followed by neck cutting was compared with the Muslim slaughter method without stunning. The total blood loss, percentage blood loss expressed as a percentage of live weight and percentage loss of estimated total blood were calculated and compared between each group. In addition, the time periods taken to reach 25, 50, 75 and 90% of total blood loss were also calculated. There was no significant difference between the two stunning groups for any of these blood loss variables. The results, subjected to statistical analyses, also showed no apparent difference in the PCV levels and meat quality parameters between treatments. These results confirm the findings with sheep and show that the bleed-out is not adversely affected by captive bolt stunning, nor improved by a neck cut without stunning in cattle. It is anticipated that these findings may help promote the use of stunning methods during Halal slaughter.

The ethical and economic significance of slaughtering animals for consumption by people of faith cannot be underestimated. On one hand, there are concerns for the welfare of animals during rearing, transport and slaughter, on the other, the market for halal meat products continues to grow at an exponential rate which has attracted the attention of independent and mainstream retailers. This paper considers the slaughter methods approved for the main animal species slaughtered for consumption by Muslims: beef, lamb, goats and poultry. It further examines the rationale for approving and rejecting certain methods of stunning and the implications this has for the welfare of animals. Areas where further research is needed to improve animal welfare during halal slaughter are also highlighted, and the authors have argued why a dialogue between animal welfare researchers, Islamic scholars and halal certification or accreditation bodies is vital in creating knowledge exchange between key stakeholders with a view to improving animal welfare during halal meat production.

Background and objective: To determine whether prior exposure of non-steroidal anti-inflammatory drugs increases perioperative blood loss associated with major orthopaedic surgery.

Methods: Fifty patients scheduled for total hip replacement were allocated to two groups (double blind, randomized manner). All patients were pretreated for 2 weeks before surgery: Group 1 with placebo drug, Group 2 with ibuprofen. All patients were injected intrathecally with bupivacaine 20 mg plus morphine 0.1 mg, in a total volume of 4 mL, to provide surgical anaesthesia.

Results: The presence of severe adverse effects caused eight patients in the ibuprofen group and six in the placebo group to terminate their participation in the trial. The perioperative blood loss increased by 45% in the ibuprofen group compared with placebo. The total (±SD) blood loss in the ibuprofen group was 1161 (±472) mL versus 796 (±337) mL in the placebo group.

Conclusions: Pretreatment with ibuprofen before elective total hip surgery increases the perioperative blood loss significantly. Early discontinuation of non-selective non-steroidal anti-inflammatory drugs is advised.

Background and objective: Multimodality treatment for patients with locally advanced primary or locally recurrent rectal cancer, including high-dose preoperative external beam radiotherapy, extensive surgery and intraoperative radiation therapy, decreases the local recurrence rates and improves survival. During this aggressive operation, the anaesthesiologist is faced with potential problems such as major transfusion requirements, hypothermia, intraoperative position changes, the need to transport the patient to the intraoperative radiation therapy applicator, and the risks associated with remote monitoring of the patient during the 10 min intraoperative radiation therapy application. The anaesthetic management and perioperative results were evaluated for the anaesthetic results and the complications.

Methods: One-hundred-and-six patients undergoing the multimodality treatment between February 1994 and March 2000 for locally advanced primary (n = 50) and locally recurrent rectal cancer (n = 56) were retrospectively evaluated for their anaesthetic results and complications.

Results: All patients were operated upon using a combination of general and epidural anaesthesia. The average duration of anaesthesia was 6 (range 3–10.5) h and the mean blood loss 3.6 (range 0.4–14) L. All patients recovered well from anaesthesia. Two patients (2%) died in the intensive care unit (34 and 48 days postoperatively) because of adult respiratory distress syndrome following postoperative haemorrhage. Severe haemorrhage during or after the operation was significantly related with the development of adult respiratory distress syndrome (P < 0.0001).

Conclusions: With adequate preoperative assessment and optimalization of the patient's condition, maintaining peroperative haemodynamic stability with the help of adequate remote monitoring, early and fast transfusion, and multidisciplinary communication, anaesthetic complications can be minimized.

Background and objective The efficiency of intraoperative autotransfusion in scoliosis surgery is poorly known but needs to be evaluated, not least because of the large blood losses in these patients. This is a retrospective analysis of transfusion requirements of 43 such patients.

Methods Records from 43 patients were studied. During surgery, the shed blood was salvaged and washed in an autotransfusion device (AT1000 Autotransfusion Unit®) and a suspension of red cells was reinfused.

Results Fifty-eight per cent of the intraoperative blood loss was salvaged. The total blood loss during the patients' hospital stay was calculated from the haemoglobin balance; 24% of this loss was salvaged by the device. Moreover, 36 of the patients needed allogeneic blood transfusion.

Conclusion The efficiency of the autotransfusion device was relatively low in relation to the total extravasation, mainly because the postoperative blood loss is substantial.

Background and objective Hypothermia may alter the disposition of opioids. Because opioids are commonly used as analgesics in the postoperative period, it is of clinical interest to clarify whether perioperatively developed hypothermia affects postoperative opioid requirements.

Methods Fifty-nine patients undergoing subtotal hysterectomy were prospectively randomized and either treated intraoperatively with forced air warming, or served as controls covered with conventional blankets without active warming. Both groups received postoperative patient-controlled analgesia with the opioid ketobemidone. Total analgesic requirements, demands, analgesic requirements over 6-h intervals and pain scores were measured for 48 h. Core temperature at the tympanic membrane and ambient room temperature were measured during the perioperative period.

Results There were no postoperative differences in analgesic requirements or pain intensity between normothermic and hypothermic patients. Patients treated with warm air had an up to 1°C higher core temperature from 0.5 h after anaesthesia induction until almost 2 h postoperatively. The actively warmed patients also had a lower intraoperative blood loss than the hypothermic patients (186 ± 27 mL vs. 308 ± 47 mL; P < 0.05).

Conclusion In a clinical setting, opioid requirements do not seem to be affected by mild postoperative hypothermia after lower abdominal surgery.